Scarlet fever

• Delayed-type skin reactivity to pyrogenic exotoxin Requires prior exposure

• Diffuse erythematous eruption that generally occurs with pharyngitis

  - Blanching

  - Many small (1 to 2 mm) papules -> "sandpaper" quality

  - groin and armpits -> trunk/extremities

  - circumoral pallor

  - strawberry tongue

  - Pastia lines = petechial lines in the antecubital fossae and axillary folds



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