Measles vs Roseola (HHV-6) and Hand-Foot-Mouth Disease
Measles and Roseola (HHV-6) and Hand-Foot-Mouth Disease are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Measles vs Roseola (HHV-6) and Hand-Foot-Mouth Disease at a glance
- Measles: Highly contagious paramyxovirus with prodromal cough/coryza/conjunctivitis and Koplik spots, followed by cephalocaudal maculopapular rash; vaccine-preventable.
- Roseola (HHV-6) and Hand-Foot-Mouth Disease: Two common pediatric viral exanthems: roseola features high fever that breaks as rash appears, while HFM produces oral ulcers with vesicles on palms and soles.
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Side-by-side comparison
| Feature | Measles | Roseola (HHV-6) and Hand-Foot-Mouth Disease |
|---|---|---|
| At a glance | Highly contagious paramyxovirus with prodromal cough/coryza/conjunctivitis and Koplik spots, followed by cephalocaudal maculopapular rash; vaccine-preventable. | Two common pediatric viral exanthems: roseola features high fever that breaks as rash appears, while HFM produces oral ulcers with vesicles on palms and soles. |
| Classic presentation | Three Cs + Koplik spots + cephalocaudal rash in an unvaccinated child.; Prodrome (3-5 days): high fever (often 40 °C), cough, coryza, conjunctivitis (the… | Roseola: high fever that breaks as the rash appears. HFMD: oral ulcers PLUS vesicles on palms and soles.; Roseola: abrupt high fever (39-40 °C) for 3-5 days… |
| Workup / key labs | Clinical case definition (fever, generalized maculopapular rash ≥3 days, plus cough/coryza/conjunctivitis) confirmed by IgM positive or RT-PCR positive.;… | Roseola: high fever 3-5 days in 6 mo-3 yr child followed by rose-pink rash on defervescence. HFMD: oral ulcers plus vesicles on palms/soles.; Both diagnoses… |
| Imaging | Chest x-ray if pneumonia suspected | Not required for typical disease; Neuroimaging and LP for HFMD with neurologic signs (EV71 brainstem encephalitis) |
| First-line treatment | Supportive care: antipyretics, hydration, isolation (airborne precautions for 4 days after rash onset); Vitamin A: 200,000 IU PO on days 1 and 2 (50,000 IU if… | Supportive care for both: hydration, antipyretics (acetaminophen, ibuprofen); HFMD: topical anesthetic mouth rinses (e.g., 'magic mouthwash'), soft cool… |
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