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This patient presented on the third pre-eruptive day with “Koplik spots” indicative of the beginning onset of measles. In the prodromal or beginning stages, one of the signs of the onset of measles is the eruption of “Koplik spots” on the mucosa of the cheeks and tongue, which appear as irregularly-shaped, bright red spots often with a bluish-white central dot.
Picture & text from CDC/PHIL. For more information see Measles Pictures from CDC