About Scarlet Fever Rashes

Scarlet fever is a bacterial disease that results in a sore throat, fever, a "strawberry tongue" and a characteristic rash. While in the past this disease was often very dangerous and resulted in significant mortality, serious illness is now rare and most cases of scarlet fever are treated just like strep throat.

Identification

Scarlet fever is caused by the release of a special kind of toxin from the bacteria Streptococcus pyogenes. The primary symptoms of the disease are a high fever, sore throat (similar to that of strep throat), a symptom called "strawberry tongue" (an inflammation of the tongue, making it look like a strawberry) and a rough, sandpaper-like rash that spreads over the upper body.

Effects

The rash of scarlet fever is unique and is often used as a diagnostic criterion. It is fine, rough textured and bright red, though it will pale when pressure is applied. There is a delay of 12 to 48 hours between the fever and the initial appearance of the rash, which generally initially forms on the chest, armpits and behind the ears. The rash is generally the worst around folds of the skin and at times can spread to include the uvula in the throat. This particular symptom is known as Forchheimer spots.

Effects

One of the many after-effects of scarlet fever is desquamation, or peeling, of the skin in the areas where the rash originally occurred. The rash begins to fade after 3 or 4 days, and the peeling follows shortly thereafter. Desquamation typically begins with the face, with peeling from around the fingers and the palms following after a week. It can also occur in the armpits, groin and on the tips of fingers and toes. While alarming and at times uncomfortable, this peeling is a normal result of the disease and is not considered dangerous.

Misconceptions

While scarlet fever has a historical reputation of being a very serious disease, past fatalities occurred when the disease spread into the blood, generating sepsis. Currently, most complications involve ear or sinus infections, pneumonia, meningitis and full body sepsis (known as malignant scarlet fever). Fortunately these complications are rare. More common immunological complications include acute glomerulonephritis, which can lead to blood in the urine, as well as rheumatic fever, which occurs when antibodies in the blood react with the body itself.

Prevention/Solution

Scarlet fever, once a feared disease of childhood, is now treated with similar medications as strep throat, using such common antibiotics as penicillin. The only real difference between its course and that of standard strep throat is the presence of diarrhea. In the case of patients with an allergy to penicillin, the antibiotics clindamycin and erythromycin can be substituted.