Symptoms of measles will generally appear after 10- 14 days of exposure to the virus.
Prodrormal phase- It begins as moderate fever accompanied by dry hacking cough, sneezing, red itchy eyes, excessive lachyrmation and running nose.
Eruptive phase- On 2nd or 3rd day of illness, the exanthema- koplik's spot begins as discrete bluish white spots inside the cheeks, opposite the second molars and may spread to lips, hard palate, conjunctival folds and vaginal mucosa.
Symptoms of measles increases in intensity for 2-4 days and then rash begin to appear on the 4th day. The early rash appears as maculopapular eruptions which blanch on pressure. It appears behind the ears, face, trunk, hairline of forehead. It may even spread downwards to extremities, palms and soles in 50% of cases. At the same time, fever begins to rise till 104 deg. Sometimes loss of appetite, malaise and lymphadenopathy also occurs.
With the onset of rash other symptoms of measles begin to subside and rash starts fading from 7 days in the same order as it is involved leaving a brown discoloration or desquamation of skin.
Sometimes severely malnourished children develop certain complications and severe exfoliation of skin.