"Catarrhal physiognomy" and Koplik's spots.

A 22-year-old female presented with a 5-day history of fever, conjunctivitis, coryza, cough, nasal discharge and 1-day of dyspnea. A maculopapular rash had appeared on her face two days ago and had spread to her upper torso and shoulders. The patient had never been vaccinated against measles. On examination, the temperature was 39.1 ◦C, with a pulse rate of 103 and a respiratory rate of 23 breaths per minute. Physical examination showed notable exudate around eyes, alae nasi and oral lips (Fig. 1A) and small white spots on the buccal mucosa that resembled grains of salt and had a reddish background (Fig. 1B, arrow). We identified them as “catarrhal physiognomy” and Koplik’s spots and diagnosed measles. The diagnosis was later confirmed by the presence of anti-measles IgM antibodies. The dyspnea was due to a mild form of measles bronchopneumonia. The patient with supportive care recovered uneventfully. Measles is a highly contagious disease caused by measles virus and was one of the most devastating infectious diseases