From the Guidelines
Measles rash typically presents as a maculopapular or morbilliform rash that begins on the face and spreads downward to the trunk and out to the extremities, as described in the most recent and highest quality study available 1. The rash is characterized by a prodrome of cough, coryza, and conjunctivitis with fever, followed by the appearance of the rash. Some key features of the measles rash include:
- Begins on the face and spreads downward to the trunk and out to the extremities
- Maculopapular or morbilliform in appearance
- Accompanied by a prodrome of cough, coryza, and conjunctivitis with fever
- Patients are contagious 4 days before the rash to 4 days after the rash appears, as noted in the study 1. Before the rash emerges, small white spots with bluish-white centers on a red background (Koplik spots) may appear inside the mouth on the inner lining of the cheeks, which are pathognomonic for measles. The progression of the rash from head to feet over several days, along with the preceding prodromal symptoms, is characteristic of measles infection and reflects the systemic spread of the virus throughout the body. It's worth noting that the rash is non-itchy in most cases, which helps distinguish it from other childhood exanthems, although this specific detail is not mentioned in the most recent study 1, it is consistent with the overall clinical presentation of measles.
From the Research
Measles Rash Presentation
- The measles rash is a key symptom of the disease, typically presenting as a maculopapular rash 2.
- The rash is often accompanied by other symptoms such as fever, cough, coryza, and conjunctivitis 3, 2.
- In some cases, the rash may be less severe or even absent in vaccinated individuals 2.
- The duration and severity of the rash can be reduced with treatment, such as ribavirin, in some cases 4.
Characteristics of Measles Rash
- The rash is typically maculopapular in nature 2, 4.
- It can be accompanied by other symptoms such as fever, malaise, cough, coryza, and conjunctivitis 3, 2, 5.
- The rash can be less severe or even absent in vaccinated individuals 2.
- In some cases, the rash can be atypical, making diagnosis more challenging 5.
Diagnosis and Treatment
- Laboratory diagnosis of measles relies on the detection of specific IgM antibodies in serum, dried blood spots, or oral fluid, or the detection of viral RNA in throat or nasopharyngeal swabs, urine, or oral fluid 2.
- Treatment of measles is mainly supportive, with a focus on managing symptoms and preventing complications 3, 2.
- Ribavirin has been shown to have a beneficial effect on measles in some cases, reducing the duration and severity of symptoms 4.