Examination revealed exudative tonsillitis (Panel A), strawberry tongue, and cervical adenopathy with tenderness. Skin examination revealed diffuse blanching erythema with punctate papules that caused the skin on his chest, abdomen, back, arms, and legs to have a sandpaper-like quality (Panel B shows the left side of his abdomen). #Clinical #PrimaryCare #ScarletFever #Rash #Tonsilitis #StreptococcusPyogenes #StrepPyogenes #NEJM