From the Research
Viral exanthems can present with diverse morphologies of rash, including macular, maculopapular, papular, urticarial, and vesicular, or sometimes a combination of these. The most typical presentation includes a maculopapular rash (flat spots and raised bumps) that often begins on the face or trunk before spreading to extremities. These rashes may be accompanied by systemic symptoms such as fever, malaise, headache, and lymphadenopathy. Specific viral exanthems have characteristic patterns, such as:
- Measles producing a descending rash with Koplik spots in the mouth
- Rubella causing a discrete pink rash with postauricular lymphadenopathy
- Roseola featuring a rash that appears after fever resolves
- Chickenpox creating pruritic vesicles in different stages of development
- Fifth disease manifesting as a "slapped cheek" appearance followed by a lacy rash on the body
- Hand-foot-mouth disease typically showing vesicles in the mouth and on extremities. According to the most recent study 1, viral exanthems are becoming increasingly diverse in their presentations due to changing environmental conditions and altered host-vector-agent interactions, making diagnosis based on clinical presentation alone more challenging. However, certain cutaneous clues can help arrive at a probable clinical diagnosis and guide further investigations. Most viral exanthems are self-limiting and resolve without specific treatment, though symptomatic care with antipyretics like acetaminophen or ibuprofen may help manage fever and discomfort 1.