Varicella Exposed: When Dewdrops on a Rose Petal Raise Concern

Welcome back, DERM Community!

Last week, we explored Tinea Versicolor: the pigment-shifting fungal infection that can baffle even the most observant clinician. Missed the pearly hypopigmented patches and their UV secrets? You can still catch the recap in our previous issue.

This week in Beneath the Surface, we’re spotlighting Varicella (a.k.a. chickenpox), a once-common childhood illness that still shows up unexpectedly and sometimes with serious consequences in adults and immunocompromised patients.

Let’s review the critical signs, atypical presentations, and what to do when this “simple virus” turns complicated.

Featured on This Week’s Chapter:

Learning Opportunities: More than just an itchy childhood illness

Chickenpox may seem like a thing of the past, a common childhood infection most of us remember from school days. But despite vaccines and medical advances, the virus behind chickenpox (varicella-zoster) still poses risks today, especially for those who aren’t immune or are medically vulnerable.

So, what exactly happens during a chickenpox infection? How contagious is it, and who needs to be concerned?

Chickenpox at a Glance

Need more than just an infographic?

We created this PDF Guide for you to read, to keep, to share.

Why It Still Matters in 2025

While chickenpox is usually mild in children, it can lead to complications like skin infections, pneumonia, or even hospitalization.

And here’s something many don’t realize: once you’ve had chickenpox, the virus stays dormant in your body and can reactivate later as shingles, a painful nerve condition that affects 1 in 3 adults.

The good news? The chickenpox vaccine is safe and effective, and it's part of most routine immunization schedules. For adults who missed the vaccine or never had chickenpox, it's still worth discussing with a doctor.

Want to see real cases with real outcomes?

Check out our course on Viral Skin Infections: we cover varicella and its treatment + many more diseases!

👋🏻 See you next Thursday, DERM community!

Thanks for joining us on Beneath the Surface.

Even “routine” rashes can carry unexpected weight. Varicella may look like a childhood relic, but as clinicians, staying alert to its atypical forms, and long-term implications, is essential. Whether you’re brushing up for board exams, seeing a puzzling case, or guiding a worried parent, knowledge is your best tool.

If you found this issue helpful, share it with your team or residents.

Until next time.

— The Derm for Primary Care Team