Revision as of 16:11, 22 April 2015 by Neil.m.young (talk | contribs) (edits to treatment with ref)



Male with varicella rash: lesions in various stages of development
Classic blister during early stage of lesion development
  • Pruritic generalized vesicular exanthem w/ mild systemic manifestations
  • Usually affects children <10y
  • Rash
    • Starts on trunk or scalp as pruritic, red macules, spreads to extremities
    • W/in 24hr rash becomes vesicular (on erythematous base)
    • Palms/soles spared
    • Lesions in various stages of development

Differential Diagnosis

Pediatric Rash


  • Tylenol, antihistamine, oatmeal baths
    • No Aspirin (may predispose to Reye's Syndrome)
  • Routine use of antiretrovirals for uncomplicated cases in immunocompetent children is not recommended in Tintinallli 7th ed
  • However, evidence shows decreased days of fever and number of lesions[1]
    • Consider Acyclovir20 mg/kg (up to 800 mg) PO q6hrs x 5 days for children >12 y/o
  • Immunocompromised[2]:
    • ≤12 yrs - Acyclovir 20 mg/kg IV q8hrs x 7-10 days
    • >12 yrs - Acyclovir 10 mg/kg IV q8hrs x 7 days


  • Can include encephalitis, pneumonia, hepatitis, strep/staph superinfection of ruptured vesicles
  • Perinatal infection in neonates may develop serious illness

See Also

Pediatric Rashes

  1. Klassen TP, et al. Acyclovir for treating varicella in otherwise healthy children and adolescents. Cochrane Database Syst Rev. 2005; (4):CD002980.
  2. Drugs for non-HIV viral infections. Treat Guidel Med Lett. 2007; 5(59):59-70.