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Varicella (Chicken Pox)
Treatment: Symptomatic control with antihistamines. Avoid aspirin, particularly in children, given possible link to Reye's syndrome. NO antivirals for uncomplicated varicella in healthy child less than 12 y/o. Otherwise consider treatment with acyclovir, PO or IV (dependent on disease severity and patient's immune status).
History and Physical Exam: May have mild prodrome of headache, myalgias and malaise. Lesions begin as papules that evolve: vesicles ("dewdrops on a rose petal") --> pustules --> crusted pustules; starts on head and migrates down towards torso and extremities. All stages of evolution are often noted simultaneously. Potential complications include pneumonitis, hepatitis, encephalitis.
Despite receiving the varicella vaccine, people can still get chicken pox although it's presentation in these cases is often less severe. The vaccine is about 86% effective.
Source
Fitzpatrick's: Color Atlas & synopsis of Clinical Dermatology. 2005.
Albrecht, Mary MD. "Treatment and preventiion of chickenpox." Up to Date. 6 October 2008.
Image: Moser MD, WebMD blog
