My 11-year-old daughter has developed a few bubble-like pinkish red patches on her face and body. Her paediatrician suspects she is suffering from chickenpox. However, she had been vaccinated against chickenpox.

The description of your daughter’s skin lesions is quite likely suggestive of a diagnosis of chickenpox (varicella) infection.

Typically, a chickenpox infection does have prodromal symptoms (the patient experiences certain complaints before the real appearance of the disease, such as headaches, lethargy, mild sore throat, runny nose and watery eyes). These can occur two to three days before the real attack. In its classical form, chickenpox-induced skin lesions appear as pinkish red patches, where few of them or in severe cases most of them can develop central vesicular or blistering lesions.

The size and depth of these blisters are suggestive of the severity of the disease and are also believed to be an indicator of any probability for post chickenpox skin scarring.

In usual cases, from its onset until complete recovery the disease can take on average around 14 days. During this period, it is generally considered to be highly contagious for those in close vicinity of the sufferer. Therefore, timely identification and isolation of the sufferer can radically reduce the risk of the disease spreading widely.

As to whether your daughter can suffer from chickenpox despite getting vaccinated, the answer is yes, this happens in a few cases. This is due to the inability of the sufferer’s immune system to produce a total immunity response after vaccination. As such certain individuals remain partially vulnerable to the disease during the period of its active outspread in their immediate surroundings. But in such cases the attack is clinically minimal with appearance of a few skin lesions as the existing partial immunity succeeds in blocking any aggressive attack of the disease. This is most likely what has happened in your daughter’s case as well.

In general, chickenpox is considered to be selflimiting and only symptomatic treatment is suggested by most physicians. For example, calamine lotion for drying the weeping lesions, with extra rest and isolation. If the sufferer develops severe productive coughing with heavy phlegm and difficulty breathing, then a course of oral or injectable antivirals and antibiotics becomes necessary to prevent/treat any suspected presence of chickenpox-pneumonia.

Accompanying fever is usually managed with simple antipyretics/analgesics like Paracetamol etc. But use of aspirin or other salicylate drugs must be avoided as they can produce a serious treatmentinduced complication known as Reye syndrome – a rare systemic disorder that can even cause brain and liver damage, usually seen in kids who have had a recent viral infection and were treated with aspirin.

Dr Ikramullah Al Nasir is a Dubai-based dermatologist