Picture Guide to Identifying Chickenpox and Shingles Rashes

Identifying Varicella Rashes in Pictures

Varicella zoster virus causes two distinct rash illnesses - chickenpox and shingles. Being familiar with pictures of varicella rashes can help identify these conditions. Chickenpox and shingles have characteristic appearances that set them apart from other possible skin conditions.

Typical Chickenpox Rash

The classic chickenpox rash goes through three stages:

• Bumps - Small red bumps develop first, mainly on the trunk.
• Blisters - Bumps fill with fluid and become pearllike blisters.
• Scabs - Blisters break, ooze, crust over, and turn into scabs.

The rash is very itchy. It appears in crops over several days, so scabs and new blisters are present at the same time. The rash spreads from the trunk to the face, scalp, arms, and legs.

Typical Shingles Rash

The shingles rash has some unique features:

• Appears on one side of the body, following a single nerve.
• Often forms a stripe-like band across the torso or face.
• May only involve the area served by 2-3 spinal nerves.
• Very painful, burning, tingling, or numb before blisters appear.

As with chickenpox, the shingles rash evolves from bumps to blisters to scabs. However, crops of new blisters usually don't develop with shingles.

Differences Between Chickenpox and Shingles

While both caused by varicella zoster virus, key differences between chickenpox and shingles include:

• Age - Chickenpox mainly affects kids. Shingles most often strikes older adults.
• Recurrence - Chickenpox only happens once. Shingles can recur.
• Distribution - Widespread for chickenpox, localized in shingles.
• Pain - Mild itching with chickenpox, severe pain preceding shingles rash.

Other Rashes to Consider

Some other rashes that may resemble a varicella virus rash include:

• Contact dermatitis - Red, itchy bumps in a pattern where an irritant touched the skin.
• Scabies - Tiny burrows visible between finger webs, wrists, waist.
• Impetigo - Honey-colored crusts on face, arms, legs.
• Herpes simplex - Painful blisters near the mouth or genitals.
• Allergic reaction - Broad red, raised welts (hives) that migrate around the body.

Pictures to Distinguish Chickenpox from Other Rashes

Chickenpox produces a very distinctive rash that pediatricians can often recognize on visual inspection. However, chickenpox can be confused with other potential skin conditions. Viewing pictures helps differentiate chickenpox from imitators.

Allergic Reaction Hives

Hives are a common allergic reaction. The rash appears as raised, well-defined red plaques that blanch with pressure. Hives tend to migrate, appearing in one area then fading as they develop elsewhere. They are usually very itchy.

In contrast, the chickenpox rash emerges as small red spots that evolve into fluid-filled blisters. The rash also spreads gradually over days, versus changing location rapidly with hives.

Scabies Infestation

Scabies is an infestation of tiny mites that burrow into the skin and lay eggs. This causes an extremely itchy rash. Visible burrows in the webs between fingers, wrists, elbows, armpits, and waist differentiate scabies from chickenpox.

The chickenpox rash begins centrally on the trunk, spreading outward. Chickenpox also causes blisters rather than just itchy bumps. However, severe scratching of chickenpox can produce excoriations resembling scabies burrows.

Impetigo Skin Infection

Impetigo is a common bacterial skin infection in children. It causes honey-colored crusted lesions that rupture easily. Impetigo tends to affect the face, arms, and legs rather than starting on the trunk.

Chickenpox could be mistaken for impetigo if only crusting pox lesions are visible. However, the small blisters that precede crusting differentiate chickenpox. Impetigo also lacks the systemic symptoms of fever and malaise that accompany chickenpox.

Distinguishing Shingles from Common Rash Mimics

Shingles can be mistaken for other more common skin conditions like eczema, psoriasis, or contact dermatitis. Recognizing key characteristics in pictures helps identify shingles correctly.

Eczema

Eczema refers to a group of inflammatory skin conditions. The rash of eczema appears as dry, red, extremely itchy patches that ooze and crust when scratched. The face, elbow creases, knees, wrists, and hands are commonly affected.

Shingles can be distinguished from eczema by its unilateral distribution following a nerve pattern. Shingles also begins with pain rather than itching. The shingles rash develops blisters rather than just dry, flaky patches.

Psoriasis

Psoriasis is an autoimmune disorder causing buildup of skin cells that form thick, silvery scales with red plaques underneath. It most often affects the scalp, elbows, knees, trunk, and genitals.

In contrast to widespread psoriasis, shingles only affects one side of the body in a narrow band. Shingles is also preceded by pain rather than itching. However, scaling lesions may obscure the blisters of shingles.

Allergic Contact Dermatitis

Contact dermatitis refers to a red, itchy rash occurring where a substance touched the skin. Common triggers include poison ivy, metals like nickel, topical antibiotics, cosmetics, and latex.

The shingles rash distribution follows a dermatome rather than contact patterns. Shingles causes blisters that crust over rather than just itchy, weeping bumps. However, severe poison ivy rash can mimic shingles.

When to Seek Medical Evaluation of a Rash

See your doctor if an unexplained rash exhibits any of the following features:

• Very painful or itchy
• Appears infected - warm, tender, spreading, pus
• Associated with fever, chills, or flu-like illness
• Follows a nerve distribution on one side
• Only seems to be getting worse, not better

Chickenpox and shingles require specific antiviral treatment to speed healing and reduce complications. Prompt medical care also prevents spread to others who are vulnerable. Sharing pictures with your physician can aid in accurate diagnosis.

Chickenpox Requires Prompt Attention

See the doctor right away if chickenpox is suspected, especially if the patient is an infant, adult, pregnant, or immunocompromised. Groups at risk for severe chickenpox need treatment and isolation precautions.

Don't Delay on Possible Shingles

Early treatment of shingles can curb the severity of the illness and postherpetic neuralgia complications. Antivirals work best if given within 72 hours of the first shingles rash lesions. Take pictures to show your doctor.

While photos help, don't rely solely on visual inspection to diagnose a questionable rash. See your doctor whenever you are concerned about an unexplained rash. Proper identification ensures appropriate care.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.