Description

• Chickenpox (Varicella) is an infection with the varicella-zoster virus that occurs most frequently during childhood and causes a characteristic itchy rash with macules that rapidly develop into papules and then vesicles
• It is highly contagious, with transmission taking place via airborne droplets or, less frequently, through direct skin contact with vesicle fluid
• In addition to fever, patients present with a highly pruritic rash covering the entire body (including the scalp). The rash is characterized by macules that rapidly develop into papules and then vesicles with an erythematous base before forming crusts. The simultaneous manifestation of the exanthem's different stages is a hallmark of the disease

Types

Prodromes

• 1–2 days before the onset of exanthem
• Presents with constitutional symptoms (e.g., fever, malaise)
• More common with primary infection in adults (less typical in children, in which rash is often the first sign of infection)

Exanthem phase

• Widespread rash starting on the trunk, spreading to the face, scalp, and extremities
• Simultaneous occurrence of various stages of rash: Appears as erythematous pruritic macules, turns to red papules and then becomes vesicles with clear fluid (“teardrop”). Finally, they become pustular and start crusting
• Fever, headache, and muscle or joint pain
• Severe pruritus

Differential diagnosis

• Insect bite reactions: produce itchy papules that mimic the early stage of chickenpox. But it does not have a typical progression of chickenpox rash and lasts much longer
• Herpes simplex: causes vesicles but are usually at mucocutaneous junction

Investigation

• Usually clinical diagnosis is made
• Tzanck smear – a smear of vesicle fluid shows multinucleated giant epithelial cells
• PCR – confirmatory

Treatments

Topical application ( calamine lotion, pramoxine gel) – Pruritus

• Oral Antihistamines
• Antiviral Therapy - Acyclovir

Ayurvedic Treatment

• Visarpa and jwara chikitsa

Kashayas

• Guduchyadi kashaya, Nimbadi kashaya, shadangam without shunti as kashaya, Chandana kashaya, Drakshadi kashaya
  • 1 year to 5 years: ½ tsp powder boiled in 1 glass water and given as divided doses mixed with sugar or jaggery
  • 5 to 10 years: 1 tsp powder boiled in 1 glass water and given as divided doses mixed with sugar or jaggery
  • 10-15 years: 1 ½ tsp powder boiled in 1 glass water and given twice daily mixed with sugar or jaggery

Gutikas

• Sudarsanam gutika, Gopeechandanadi gutika
  • 1-6 Years: ½ tab tds
  • 6-15 years: 1 tab tds

Arishtas

• Amrutarishta, Punarnavasava, Saribadyasava, Surasaasava
  • Upto 2yrs- ½ tsp arishta diluted with 1 tsp water
  • 2-5 years- 2.5ml-5ml diluted with 5 ml boiled water
  • 5-10 years- 10ml
  • 10-15 years- 15ml

Department

Kaumarabhrithya