Symptoms and Signs
Scarlet fever is characterized by:
- Sore throat
- Fever
- Bright red tongue with a "strawberry" appearance
- Forchheimer spots (fleeting small, red spots on the soft palate) may occur
- Characteristic rash:
-
- the rash is fine, red and rough-textured
- blanches upon pressure
- appears 12–72 hours after the fever
- generally starts on the chest, armpits and behind the ears. It may also involve the groin.
- the face often shows red cheeks and a characteristic pale area around the mouth (circumoral pallor)
- is worse in the skin folds. These Pastia lines (where the rash runs together in the armpits and groin) appear and can persist after the rash is gone.
- may spread to cover the uvula
- begins to fade three to four days after onset and desquamation (peeling) begins. "This phase begins with flakes peeling from the face. Peeling from the palms and around the fingers occurs about a week later." Peeling also occurs in axilla, groin and tips of the fingers and toes.
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