Circumoral pollar of scarlet fever
The face is flushed but a pale zone is left around the mouth (circumoral pallor). The tongue has a white coating with red spots. As the rash fades there is skin peeling. Prompt treatment with penicillin is indicated to avoid the complications of streptococcal infection-RHEUMATIC FEVER or GLOMERULONEPHRITIS. Because of its similar clinical presentation to scarlet fever, it was initially thought to be caused by a Streptococcus. It is now known to becaused by a Gram negative bacillus—Yersinia pseudotuberculosis. Kawasaki's disease is another important differential, especially in its incomplete form. thought to be caused by a Streptococcus. It is now known to becaused by a Gram negative bacillus—Yersinia pseudotuberculosis. Kawasaki's disease is another important differential, especially in its incomplete form. 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) Paranoia. Hallucinations. A characteristic rash, which: is fine, red, and rough-textured, blanches upon pressure
