Pediatrics

Chickenpox rash

What is chickenpox?

Chickenpox is a disease caused by the varicella zoster virus.

The virus is highly infectious and is transmitted through a droplet infection. It can be transmitted several meters above the air, hence the term chickenpox. After the infection, usually in childhood, the affected person receives lifelong immunity. However, in 20% of cases, shingles can occur after years of the virus remaining in the body. The virus spreads along sensitive nerve fibers and causes a belt-shaped, radiating rash.

Even the simple chickenpox infection shows symptoms such as fever and general malaise as it progresses, small, red, itchy pox.

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Causes of the rash in chickenpox

The rash caused by chickenpox usually starts around 14 days after infection.

It manifests itself characteristically in the form of small, red, itchy spots that develop into blisters with clear liquid within a few hours. After a day or two, the blisters burst and crust. The cause of the blistering is the multiplication of viruses in the skin.

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More precisely, after infection of the mucous membranes through droplet transfer, the first viraemia occurs. The virus enters the blood vessels in the skin. There it attacks the cells around the vessels, the so-called endothelial cells. The virus begins to multiply in the endothelial cells. To prevent this increase, the body's own immune system reacts by sending out inflammatory cells, which is reflected in the form of the rash.

Read over Chickenpox in adults.

Concomitant symptoms of chickenpox

In addition to the characteristic rash is common Fever and fatigue primary infection as an accompanying symptom.

Depending on the body area affected, it can also lead to Central nervous system involvement come with symptoms such as unsteady gait and stiff neck. Also one lung infection can occur in severe courses.

The infection with chickenpox is a special case during pregnancy there. This can lead to Deformities of the unborn child.

The most common, fortunately harmless, complication is Hypopigmentation the skin where vesicles crust. In some cases, too local scars back.

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Therapy of rash in chickenpox

If the course is benign, usually only one symptomatic therapy recommended. This includes:

- cooling the pustulesbecause heat increases the itchiness.

- Trimming the fingernailsto prevent the vesicles from being scratched and thus prevent bacterial superinfections. The risk of scarred healing increases as the blisters are scratched open

- Antihistaminergic creamto suppress the itching

- Paracetamol or Ibuprofen, to treat fever

[Caution! Acetylsalicylic acid, Aspirin, is contrainduced in childrenas there is a so-called Reye-syndrome can cause, with severe neurological damage]

Have a special position in therapy immunocompromised patients, they should always be given antiviral therapy. Frequently used means are Acyclovir or Vidarabin.

With children over 12 years Without vaccination, drug therapy can be considered if the rash erupts Max. 24 hours behind.

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Duration of varicella infection

After a incubation period from approx. 10-20 days shows up with a benign course 3-4 days an improvement, with Healing of the crusted vesicles.

If you scratch it, however, it can bacterial superinfections for example with Staphylococcus aureus such complications delay healing significantly.

As a rule, the patient receives one after the infection has been overcome lifelong immunity if the course is particularly easy and very early, it can lead to another Symptoms flare again come.

In about 20% of the cases, however, a Outbreak the varicella zoster infection in the sense of a Shingles. As a virus of the herpes virus family, the varicella zoster virus has the ability to persist in nerve nodes.

In response to an unspecific stimulus, there can be a re-propagation of the virus come with involvement of sensitive nerves. The characteristic is belt-shaped radiating rash and pain along the course of the sensitive skin nerves.

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Vaccination against varicella zoster virus

Since 2004 the Varicella zoster vaccination together with the vaccination against mumps, measles and rubella officially from the STIKO recommended.

It is one Life vaccine, that is, the body is actively forming Antibodies to the vaccine being given. At the same time, it forms memory cells that remember when they come into contact with vaccine-like structures and upregulate specific antibody production again. So can 70-90% of the vaccinated patients one lifelong immunity receive.

If there is no vaccination protection in the form of active immunization, the Possibility of passive immunization. In this case, no antigens are administered to the patient, but the specific antibodies directly. The disadvantage of such immunization is that Failure to form memory cells and thus only one temporary protection. Likewise, passive immunization cannot be administered after infection, but must also be carried out before exposure.

There are patients with an indication for this method unvaccinated pregnant women in a risk environment. Also babywho develop varicella infection during pregnancy are given a combination of acyclovir and the antibodies after birth.

Pathways of infection of varicella zoster infection

As already mentioned, the varicella zoster virus is mainly transmitted through the air and respiratory tract. Another source of infection, however, is transmission through the skin.

When the vesicles burst, e.g. Frequent scratching can lead to smear infections. Contact persons can become infected through small injuries in the skin or through the mucous membranes. Close contact should therefore be avoided in the absence of immunity.

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