The typical case of measles actually starts with a fever, runny nose, hacking cough, and red eyes. After two to four days of these symptoms, the patient may develop spots within the mouth called Koplik's spots. These spots look like little grains of white sand surrounded by a red ring and are usually found inside the cheek toward the back of the mouth (opposite the first and second upper molars).
The skin rash (also known as an exanthem or exanthema) appears three to five days after the onset of the initial symptoms (fever, cough, runny nose, and red eyes). The rash is a flat to slightly raised (maculopapular) red rash that usually last five to six days. It begins at the hairline and then progresses to the face and upper neck. Over the next two to three days, the rash progresses downward to cover the entire body, including the hands and feet. The rash has mostly distinct lesions, but some may overlap (become confluent). Initially, these lesions will turn white when you press on them (blanch). After three to four days, they no longer will blanch. As the rash begins to fade, there will often be a fine flaking of the skin (desquamation). The rash fades in the same order that it appears.
The fever that occurs with measles is called a stepwise fever. The patient starts with a mild fever that progressively gets higher. Fevers often reach temperatures greater than 103 F (39.4 C).
Although not as common as other symptoms, some patients may have a sore throat.
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