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A child with Kohlerâs disease may present similarly to a child with a foot injury. An examination will reveal pain and tenderness over the dorsomedial midfoot, with or without local skin changes. Affected children typically walk with a limp or antalgic gait, with weight bearing on the lateral side of the foot.
Koplik spots (small bluish yellow spots) occur in the mouth on buccal mucosa. The maculopapular rash appears first on the head, and then progressively spreads over the chest, trunk, and then limbs, eventually covering the entire body. Infection of the measles virus occurs through the respiratory tract. The receptor for the measles virus is the human complement regulatory cofactor protein CD46.