Overview

Measles rash is a hallmark feature of measles, a highly contagious viral infection caused by the measles virus. It is characterized by a distinctive red or reddish-brown rash that typically starts on the face and spreads to the rest of the body. Measles was once a common childhood illness but has become less frequent in many countries due to widespread vaccination programs. However, outbreaks can still occur, especially in areas with low immunization rates.

Causes

The primary cause of measles rash is infection with the measles virus, a member of the paramyxovirus family. Measles spreads through respiratory droplets when an infected person coughs or sneezes. The virus enters the body through the nose, mouth, or eyes and quickly multiplies, triggering the immune response that leads to the characteristic rash. Factors that increase the risk of measles include lack of vaccination, weakened immune systems, and exposure to unvaccinated individuals.

Symptoms

Measles rash typically appears three to five days after the onset of early measles symptoms. The progression includes:

• Early symptoms: High fever, cough, runny nose, and red, watery eyes (conjunctivitis).
• Koplik spots: Small white spots with bluish centers on the inside of the cheeks, which appear a day or two before the rash.
• Rash appearance: Begins on the face, particularly near the hairline, then spreads downward to the neck, trunk, arms, legs, and feet.
• Rash characteristics: Flat red spots, sometimes raised, that may join together as they spread. The rash usually lasts about 5 to 6 days before fading.
• Other symptoms: General fatigue, body aches, and sensitivity to light (photophobia).

Diagnosis

Measles rash is often diagnosed based on clinical symptoms and patient history, particularly in areas with known outbreaks. Diagnostic steps may include:

• Physical examination: Identification of rash pattern and Koplik spots.
• Medical history: Recent exposure to infected individuals or travel to areas with active outbreaks.
• Laboratory tests: Blood tests to detect measles-specific IgM antibodies or PCR tests to identify the measles virus RNA.

Treatment

There is no specific antiviral treatment for measles; care is primarily supportive and aims to relieve symptoms and prevent complications:

• Rest and hydration: Adequate rest and fluids to prevent dehydration.
• Fever management: Paracetamol or ibuprofen to reduce fever and alleviate body aches.
• Vitamin A supplementation: Recommended especially for children, as it reduces the severity of measles symptoms and lowers complication risks.
• Monitoring for complications: Watch for signs of pneumonia, ear infections, diarrhea, or encephalitis, which may require additional treatment.

Prognosis

The prognosis for measles rash is generally good in healthy, well-nourished individuals who receive appropriate care. The rash usually fades within a week without leaving scars. However, measles can lead to serious complications, particularly in young children, pregnant women, and those with weakened immune systems. Vaccination remains the most effective way to prevent measles and its associated complications. With timely supportive care, most individuals recover fully, though full return to normal energy levels may take several weeks.