​Dermatology - Measles

​Dermatology - Measles 
The symptoms of measles, a highly contagious viral illness, include fever, coryza, coughing, mucocutaneous rash, and conjunctivitis. The prevention of infection is greatly enhanced by immunization.
Significant morbidity and mortality are possible. Despite being rare in nations where vaccination is widely practiced, measles kills more than 150,000 people annually worldwide. Recent outbreaks have occurred in the US as vaccination refusal has grown. Aerosolized respiratory droplets from coughing and sneezing transmit the measles. Those who have the infection can spread to others up to five days after the lesions start to show.

A prodrome of fever, malaise, photophobia, conjunctivitis with lacrimation, upper respiratory symptoms (coryza, hacking cough similar to barking dogs), and periorbital edema is present. The rash appears and gets worse before these symptoms start to go away.
Damage
Clusters of tiny, bluish white dots on a red background that occur in the mouth cavity on the buccal mucosa on the second or third day of a feverish illness are known as Koplik spots and are a reliable indicator of measles. Erythematous macules and papules occur on the forehead behind the ears and along the hairline on the fourth febrile day. After that, by the third day, the rash has expanded inferiorly and centrifugally to encompass the face, torso, limbs, palms, and soles of the feet. Confluence of initially separate lesions is possible, particularly on the face, neck, and shoulders. Lesions eventually disappear in the order that they first develop, leaving behind a mild desquamation or a persistent yellow-tan stain.

The measles antigen can, but is not required to, be found in respiratory secretions to confirm the clinical diagnosis. Drug responses, scarlet fever, Kawasaki disease, and other viral exanthems are also included in the differential.

For the majority of cases, measles is a self-limiting infection. As you watch for potential consequences of infections (respiratory, ear), thrombocytopenia, and encephalitis, give supportive and symptomatic therapy.