How is enanthem 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

The characteristic enanthem generally appears 2-4 days after the onset of the prodrome and lasts 3-5 days. Small spots (Koplik spots) can be seen inside the cheeks during this early stage (see the image below).

Koplik spots in measles. Photograph courtesy of Wo Koplik spots in measles. Photograph courtesy of World Health Organization.

The exanthem usually appears 1-2 days after the appearance of Koplik spots; mild pruritus may be associated. On average, the rash develops about 14 days after exposure, starting on the face and upper neck (see the image below) and spreading to the extremities. Immunocompromised patients may not develop a rash.

Face of boy with measles. Face of boy with measles.

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