Varicella, also known as chickenpox, is a self-limited benign disease caused by primary varicella-zoster virus (VZV) infection characterized by fever, malaise, and generalized pruritic vesicular rash.
The average incubation period is 14-16 days. It is transmitted via direct contact with vesicular fluid or inhalation of aerosolized respiratory secretions or via droplet route during face-to-face contact.
Hallmark sign is pruritic rash that begins in the scalp and face which eventually spreads to the trunks and extremities.

Differential Diagnosis


  • Other skin eruptions that may be confused with varicella-zoster virus (VZV) infection
    • Viral exanthems, impetigo, insect bites, scabies, erythema multiforme, papular urticaria, drug eruption, hand-foot-mouth disease, disseminated herpes zoster and other vesicular dermatoses which may appear with the same diffused rash typical of varicella

Herpes Zoster

  • Pain experienced with herpes zoster is often misdiagnosed as myocardial infarction (MI), pleurisy, cholecystitis, appendicitis, duodenal ulcer, ovarian cyst, herniated intervertebral disc, thrombophlebitis, renal or biliary colic
  • Zoster rash may be confused with impetigo, contact dermatitis, folliculitis, scabies, insect bites, urticaria, candidal infection, dermatitis herpetiformis, eczema herpeticum, drug eruptions
  • Zoster sine herpete
    • Dermatomal pain with positive serologic and virologic evidence but without rash
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
Editor's Recommendations
Most Read Articles
Tristan Manalac, 13 Mar 2018
In patients with end-stage renal disease (ESRD), varicella appears to be associated with high mortality and morbidity, a recent Singapore study has shown. Researchers thus recommend vaccination in ESRD patients seronegative for varicella.
Roshini Claire Anthony, 09 Mar 2018

Individuals using opioid analgesics may be at an elevated risk of invasive pneumococcal disease, particularly those using long-acting, high-potency, immunosuppressive, or high-dose opioids, results of a nested case-control study show.

09 Mar 2018
Apart from being tolerable and feasible, pre- and post-transplantation hepatitis C virus (HCV) treatments prevent HCV infection in non–HCV-infected recipients (ie, HCV D+/R− transplantation) of kidneys, a recent open-label nonrandomized trial in a single centre has shown.
6 days ago
Use of antiviral treatment for colonic cytomegalovirus (CMV) infection significantly improves short- and long-term surgery-free survival in patients with ulcerative colitis (UC), according to the results of a small-scale study.