WEDNESDAY, Jan. 28, 2026 (HealthDay News) -- The clinical presentation of measles in pediatric patients is variable, with atypical presentations more frequent in partially vaccinated or immunocompromised patients, according to research published in the January issue of SKIN.

Kallie Crowl, from the Des Moines University College of Osteopathic Medicine in Iowa, and colleagues conducted a retrospective synthesis of 10 pediatric case reports and series to characterize the range of clinical presentations of pediatric measles in the context of vaccination status, immune history, and access to care.

The researchers found that 80 percent of the cases reviewed exhibited the classic cephalocaudal rash progression, while some showed atypical patterns, including sparing of extremities or back-to-front distribution. In partially vaccinated or immunocompromised patients, atypical presentations were more frequent. There were inconsistent reports of Koplik spots. Due to overlap with other pediatric conditions and low clinical suspicion, diagnostic delays were common, especially among older children and adolescents.

"This review underscores a concerning erosion in the clinical recognition of measles, particularly in pediatric populations," the authors write. "Declining provider familiarity, atypical presentations, and misplaced diagnostic assumptions have contributed to delayed and often inaccurate diagnoses, even when patients exhibit classic features."

Abstract/Full Text