'X' Marks the 'Pox' for Mischievous Girls

Marker, imagination lead to sisters' feigned cases of disease

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By
HealthDay Reporter

WEDNESDAY, Oct. 6, 2004 (HealthDayNews) -- Imagine putting your healthy daughters to bed one evening only to find them covered with red spots the next morning. What mysterious illness could come on so quickly? And what disease causes a skin rash that doesn't itch and has no other symptoms?

It's "faux pox," a disease strikingly similar in appearance to chicken pox -- particularly before one has had that first cup of morning coffee.

The cause of faux pox is a red marker coupled with the imagination of two young girls.

The first documented cases of the disease occurred at the Indianapolis, Ind., home of Gordon and Darla Berry, who awoke one morning to find their daughters -- Amelia, 7, and Joanna, 3 -- covered with red spots. The rash was most evident on uncovered parts of the body, such as the face and the neck. The girls didn't appear ill, and seemed to have no symptoms other than the rash.

"Instead, the rash was associated with excessive whispering, uncontrolled giggling, and avoidance of eye contact with their parents," wrote their father, Gordon Berry, in a letter appearing in the Oct. 6 issue of the Journal of the American Medical Association.

Joanna offered this explanation for the perplexing disorder, "I have chicken pops!"

Eventually, under the threat of television suspension, the girls confessed that they had made up their illness to surprise an aunt who was coming to visit. Their inspiration was a television character who had come down with the chicken pox, and the plan was to stay in bed until their aunt came and discovered the mysterious rash.

Childhood exuberance won out, however. Little Joanna just couldn't contain her excitement, and had to show off her disease to Mom and Dad, who quickly realized the nature of the illness.

However, Berry confessed that "in the morning darkness, it wasn't immediately obvious that the markings were faked. Their giggling was the ultimate giveaway."

"They were expeditiously treated with a hot bath, and their recovery was complete and uneventful," Berry wrote.

As far as long-term consequences, Berry said, "I fear for the more complicated schemes they'll cook up as teenagers."

Alan Hilfer, a pediatric psychologist at Maimonides Medical Center in New York City, said it's pretty common to see children feigning illness.

"My kids learned very early how to put a thermometer near a radiator," he laughed, adding, "These illnesses seem to occur especially when they're less well prepared than they should be."

Young children, he said, may experience anticipatory anxiety, particularly about things happening at school. Children may get that butterflies in the stomach feeling and complain of a stomachache.

"Stomachaches are pretty common when kids are nervous. They may feel a little twinge and magnify it. Usually, once they get into the situation they're nervous about, they start to feel OK," he said.

If the feeling persists for days or weeks, he said it's time to do more investigating. First, have your pediatrician rule out a physical cause of the distress. If there's no physical cause, and your child is experiencing distress in more than one setting, Hilfer said to try to figure out what might be causing the child stress. Is it school work? Peers? Family problems? If you can't get to the bottom of it yourself, he added that professional intervention may be necessary.

Fortunately, that wasn't the case with the Berry girls. Darla Berry took some photographs of the girls sporting their faux pox, and Gordon Berry thought he'd have some fun stumping a friend, Dr. William Cordell of the department of Emergency Medicine at Indiana University School of Medicine in Indianapolis, with the photos.

"At first glance, I thought it might be varicella [chicken pox], but on closer inspection, the rash didn't have the classic vesicles [small blisters] of that illness," said Cordell. "Furthermore, the girls were too cheerful in the photo."

Berry quickly let Cordell off the hook and told him about the girls' prank. They decide it would make an interesting addition to the medical literature and submitted their case report to the journal; Cordell was a co-author of the letter.

On a more serious note, however, Cordell pointed out that chicken pox is still responsible for about 11,000 hospitalizations, 100 deaths and countless hours of childhood misery every year. A vaccine for chicken pox became available in the mid-1990s.

"Unfortunately, most illnesses definitely won't turn out to be a prank like the faux pox perpetrated by the Berry girls. We shouldn't get complacent about preventing illness wherever possible," he said.

More information

To learn more about the real chicken pox, visit the U.S. Centers for Disease Control and Prevention.

SOURCES: William Cordell, M.D., department of emergency medicine, Indiana University School of Medicine, Indianapolis; Gordon Berry, father, Indianapolis, Ind.; Alan Hilfer, Ph.D., pediatric psychologist, Maimonides Medical Center, New York City; Oct. 6, 2004 Journal of the American Medical Association; photo courtesy Darla Berry

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