Are my rash and spots from chickenpox exposure?

Question

Hello doctor,

I have developed a rash mainly on my feet and legs, a few spots on my arms, torso, and thighs. I had chicken pox when I was seven or eight years old. I was exposed two weeks ago when there was an outbreak of chickenpox at my son's school.

I’ve been sick for the last two days with a headache, tiredness, and body aches. I'm on Pristiq right now. Can you tell me if this looks like chickenpox or something else?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

My knowledge is current only through October 2023. I hope you are doing well, and thanks for getting in touch.

Given your history and the appearance of the rash in the photos (redacted to protect patient identity), this presentation does not fit with chickenpox.

Chickenpox usually causes a widespread rash of fluid-filled blisters (vesicles) that appear in crops and are in different stages of development at the same time (red spots, blisters and crusts together). It usually begins on the face and trunk and then spreads outward and is often associated with fever.

In your situation, the lesions are small red papules without blisters, mostly on the legs and feet, a few scattered spots elsewhere. The pattern and morphology are not classic for varicella. Also, a history of chickenpox in childhood usually gives long-term immunity, so you are very unlikely to get it again.

The rash is more likely to be a benign inflammatory eruption such as insect bites (papular urticaria) or a post-viral rash. Especially as you have recently had symptoms of feeling unwell, including headache, fatigue, and body aches. Viral illnesses can cause non-specific rashes that usually resolve on their own. Also, the distribution of exposed areas supports this possibility.

Management is supportive at this stage. In most cases, it is enough to keep the skin clean, not to scratch and to use soothing creams or an oral antihistamine for itching. You will need to watch the rash for the next few days.

If any of the following occur, seek medical review promptly: fluid-filled blisters, rapidly spreading rash, high or persistent fever, signs of skin infection (increasing redness, warmth or pus) or if the child becomes significantly unwell.

There is no clinical evidence of active chickenpox overall and this appears to be a self-limited, non-serious skin eruption.

I hope this helps you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Yes, all the more likely a rash from bugs. These reactions are very common and can result in small red spots, which can persist for several days even if there are no new bites.

This is a very typical pattern for this type of reaction and not typical for chicken pox. Chicken pox usually causes fluid-filled blisters starting on the trunk, not the legs and feet. The pattern you describe with more spots on the legs and feet and fewer scattered on arms and torso is typical.

Another possibility is a mild post-viral rash, which can appear suddenly and resolve spontaneously. Supportive care is sufficient at this point. Go to the doctor only if blisters form, fever is high, or your child looks sick.

Most often, it still looks like a benign, non-contagious rash.

I hope this helps you.

Thank you.