How is rash characterized in measles?

Updated: Jun 06, 2019
  • Author: Selina SP Chen, MD, MPH; Chief Editor: Russell W Steele, MD  more...
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Answer

Rash

  • On average, the rash develops about 14 days after exposure

  • Mild pruritus may also occur

  • Blanching, erythematous macules and papules begin on the face at the hairline, on the sides of the neck, and behind the ears

  • Within 48 hours, the lesions coalesce into patches and plaques that spread cephalocaudally to the trunk and extremities, including the palms and soles, while beginning to regress cephalocaudally, starting from the head and neck

  • Lesion density is greatest above the shoulders, where macular lesions may coalesce

  • The eruption may also be petechial or ecchymotic in nature

  • Patients appear most ill during the first or second day of the rash

  • The exanthem lasts for 5-7 days before fading into coppery-brown hyperpigmented patches, which then desquamate

  • Immunocompromised patients may not develop a rash


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