This image displays the sandpaper-like appearance on the chin and a red tongue with red dots (red strawberry tongue) typical of scarlet fever. This image displays the previously pink, sandpaper-like rash of scarlet fever starting to peel and improve. This image displays the tiny pink bumps of scarlet fever beginning to peel as the patient improves. This image displays the faint pink sandpaper-like rash of scarlet fever on the neck and trunk. Numerous tiny red bumps of scarlet fever are sometimes more easily felt than seen (giving the typical sandpaper-like feel). This is the typical "white strawberry tongue" of scarlet fever, with a white coating with red dots on the surface.
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Picture of Scarlet Fever: This image displays the sandpaper-like appearance on the chin and a red tongue with red dots (red strawberry tongue) typical of scarlet fever. Divider line
This image displays the sandpaper-like appearance on the chin and a red tongue with red dots (red strawberry tongue) typical of scarlet fever.
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Signs and Symptoms
Scarlet fever is accompanied by a sandpaper-like rash of 1–2 mm red bumps, which merge together, starting on the neck, then moving to the trunk, and finally to the arms and legs (extremities). It is sometimes a bit itchy. If scarlet fever develops on body creases (armpits, elbow folds), red streaks may appear.

Fever, chills, body aches, nausea, vomiting, and loss of appetite may occur.

When the throat is the main area of infection, the tonsils may become enlarged, red, and tender. Other areas (lymph nodes) in the neck may become swollen. At first, the tongue has a white coating, giving a "white strawberry" tongue appearance, which then falls off (sheds) to reveal a bright red strawberry tongue. The rash does not affect the palms and soles at first, but later on, these areas may peel. The rash usually lasts for 4–5 days, and as it fades (subsides), skin on the neck and face start to peel, and eventually the hands and feet start to peel as well.
Last Modified: 29 Jan 2008
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