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Scarlet fever consists of streptococcal infection, usually
accompanied by a characteristic rash. The rash arises from the effects
of a group of toxins, currently designated streptococcal pyrogenic exotoxins
and previously known as erythrogenic or scarlet fever toxins. Studies
have suggested that development of the scarlet fever rash may reflect
a hypersensitivity reaction requiring prior exposure to the toxin.
The symptoms of scarlet fever are the same as those of
alone. The rash typically begins on the first or second day of illness
over the upper trunk, spreading to involve the extremities but sparing
the palms and soles. The rash is made up of minute papules, giving a characteristic
"sandpaper" feel to the skin.
Associated findings include circumoral pallor,
"strawberry tongue" (enlarged papillae on a coated tongue, which later
may become denuded), and accentuation of the rash in the skin folds (Pastia's
lines) "raspberry tongue". Subsidence of the rash in 6 to 9 days is followed
after several days by desquamation of the palms and soles.
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The illness is spread by the same means as
Treatment with gram positive antibiotics. Other than the occurrence
of the rash, the treatment and course of scarlet fever are no
different from those of any strep throat.