Chickenpox in a Child

A pruritic, erythematous rash developed in a 6-year-old boy over 5 days. The rash erupted in crops; the lesions appeared initially as rose-colored macules, progressed rapidly to papules and vesicles, and finally crusted (A). The distribution of the lesions—with the greatest concentration on the trunk—is typical of chickenpox. Postinflammatory scarring may result from chickenpox (B).¹ Symptomatic relief of itching can be obtained with topical antipruritic agents, such as those containing pramoxine and menthol(, and with hydroxyzine( hydrochloride or another systemic antihistamine. Because of its association with toxic encephalopathy in patients with chickenpox, topical or oral diphenhydramine( is not recommended.^2,3Meticulous attention to hygiene is necessary to prevent secondary bacterial infections, which require topical or systemic antibiotic therapy. Such secondary infections are impetigo and cellulitis.