AAD releases measles resource center for dermatologists amid 2025 US outbreaks
Key takeaways:
- A total of 301 measles cases have been reported in the U.S. in 2025, occurring in 15 states.
- Dermatologists should look out for the cutaneous signs of measles such as a rash or white spots inside cheeks.
The American Academy of Dermatology has created a measles resource center for dermatologists to stay prepared during the current U.S. measles outbreak.
Created by the AAD’s Emerging Diseases Task Force in 2025, the AAD’s measles resource center provides “resources to help recognize measles, clinical and vaccine information, office preparedness” and more, according to the academy’s website.
Background
“In 2000, measles was declared eliminated,” Carrie Kovarik, MD, FAAD, professor of dermatology and medicine at the Perelman School of Medicine at the University of Pennsylvania, told Healio. “This was due to the very high vaccination rates in children before starting kindergarten; however, the 95% coverage target is now decreasing and much lower in some areas.”
According to the CDC, the measles, mumps and rubella vaccination coverage for U.S. kindergartners decreased from 95.2% in the 2019 to 2020 school year to 92.7% in the 2023 to 2024 school year, putting approximately 280,000 kindergartners at risk.
As of March 13, three measles outbreaks, defined as three or more related cases, have occurred in 2025, with 93% of cases this year being associated with outbreaks, according to the CDC. In 2024, 16 outbreaks were reported, 69% of which were associated with outbreaks.
Currently, there have been cases reported in 14 states: Alaska, California, Florida, Georgia, Kentucky, Maryland, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, Texas, Vermont and Washington.
As Healio previously reported, there has been one confirmed measles-related death in Texas and another under investigation in New Mexico. The vaccination rates in these states during the 2023 to 2024 school year, according to the CDC, are 94.3% in Texas and 95% in New Mexico. For comparison, the highest vaccination rate is held by West Virginia at 98.3%, whereas the lowest is in Idaho at 79.6%.
According to Kovarik, the number of measles cases have been increasing in the U.S. with 285 cases confirmed in 2024 and 301 in 2025 — a stark contrast to the 59 reported cases in 2023.
On the AAD resource center, the academy states that 95% of reported measles cases have occurred in individuals who are unvaccinated or have not listed a vaccination status based on the CDC’s findings.
“It is complicated why vaccine rates are decreasing,” Kovarik told Healio. “In the areas where there are currently outbreaks of measles, many of the kids are home schooled, so there are no vaccination requirements. Also, in Texas, there are vaccine exemptions that allow parents not to vaccinate on ‘reasons of conscience, including religious belief.’”
According to Kovarik, lawmakers are currently filing more bills to strengthen these exemptions.
However, Kovarik notes that “if vaccination rates do not increase, or continue to decrease, the cases will only rise.”
Guidance for dermatologists
Because the disease has cutaneous manifestations, dermatologists should look out for the clinical features of measles in their patients, Kovarik states. Before the rash appears, patients may present with a cough, fever, conjunctivitis and runny nose. They may also have a sore throat and/or white spots on the inside of their cheeks, known as Koplik spots, Kovarik explained.
The CDC states that individuals must have a fever and rash and either a cough, runny nose or conjunctivitis to be diagnosed with measles.
“The rash usually starts at the hairline or behind the ears and spreads downward as flat red macules that coalesce,” Kovarik said. “There is usually an incubation period of 7 to 21 days between exposure and rash onset.”
Kovarik recommends that dermatologists be prepared with measles testing equipment, including nasopharyngeal or throat swabs for reverse transcription polymerase chain reaction. If a dermatologist suspects their patient has a case of the measles, immediately bring the patient into a separate room and have the family wear face masks.
“Since most people have not seen a case of the measles, it is best for dermatologists to familiarize themselves with the clinical findings, diagnostic tests, treatment and reporting criteria,” Kovarik told Healio. “These can be found on the AAD resource page and on the CDC informational pages.”
Reference:
- Measles cases and outbreaks. https://www.cdc.gov/measles/data-research/index.html. Updated March 14, 2025. Accessed March 19, 2025.
- Measles resource center. https://www.aad.org/member/clinical-quality/clinical-care/emerging-diseases/measles. Accessed March 19, 2025.