Editing Scarlet fever (section)

===Rash===
[[File:Scarlet fever 2.jpg|thumb|upright|Scarlet fever rash in light skin]]
[[File:Scarlet fever rash.jpg|thumb|upright|Scarlet fever rash in dark skin]]
[[File:Scarlet fever 1.1.JPG|thumb|right|Red cheeks and pale area around the mouth in scarlet fever]]
[[File:Scarlet Fever.jpg|thumb|upright|Characteristic red cheeks and rash of scarlet fever]]

The characteristic rash has been denoted as "scarlatiniform", and it appears as a diffuse redness of the skin with small bumps resembling goose bumps.<ref name="Kaspar-2015">{{Cite book|title=Harrison's Principles of Internal Medicine, 19th edition|last1=Kaspar|first1=Dennis|last2=Fauci|first2=Anthony|last3=Hauser|first3=Stephen|last4=Longo|first4=Dan|last5=Jameson|first5=J. Larry|last6=Loscalzo|first6=Joseph|publisher=McGraw Hill Education|year=2015}}</ref> It typically appears as small [[macule|flat spots]] on the neck or torso before developing into [[papule|small bumps]] that spread to the arms and legs.<ref name=Goldman2020>{{cite book |last1=Stevens |first1=Dennis L. |last2=Bryant |first2=Amy E. |last3=Hagman |first3=Melissa M. |editor1-last=Goldman |editor1-first=Lee |editor2-last=Schafer |editor2-first=Andrew I. |title=Goldman-Cecil Medicine |date=2020 |publisher=Elsevier |location=Philadelphia |isbn=978-0-323-55087-1 |page=1873 |edition=26th |volume=2 |chapter-url=https://books.google.com/books?id=7pKqDwAAQBAJ&pg=PA1873 |language=en |chapter=274. Nonpneumococcal streptococcal infections and rheumatic fever |access-date=30 January 2023 |archive-date=9 April 2023 |archive-url=https://web.archive.org/web/20230409103645/https://books.google.com/books?id=7pKqDwAAQBAJ&pg=PA1873 |url-status=live }}</ref> It tends to feel rough like sandpaper.<ref name=Cohen2022>{{cite book |last1=Denny |first1=George O. |last2=Cohen |first2=Bernard A. |editor1-last=Cohen |editor1-first=Bernard A. |title=Pediatric Dermatology |date=2022 |publisher=Elsevier |location=Philadelphia |isbn=978-0-7020-7963-4 |page=191-192 |chapter-url=https://books.google.com/books?id=5cM2EAAAQBAJ&pg=PA192 |language=en |chapter=7. Reactive erythema |access-date=30 January 2023 |archive-date=7 April 2023 |archive-url=https://web.archive.org/web/20230407141819/https://books.google.com/books?id=5cM2EAAAQBAJ&pg=PA192 |url-status=live }}</ref> The cheeks might look flushed with a pale area around the mouth.<ref name=CDC2022/> The scarlet fever rash generally looks red on white and pale skin, and might be difficult to visualise on brown or black skin, in whom the bumps are typically larger, the skin looks like sandpaper, and the perioral pallor less obvious.<ref name=Zitelli2023/> The palms and soles are spared.<ref name=Goldman2020/> The reddened skin blanches when pressure is applied to it.<ref name=Zitelli2023/> The skin may feel itchy, but is not painful.<ref name=Zitelli2023/> A more [[Pastia's lines|intense redness]] on the inside of skin folds and creases might be noticed.<ref name=Pardo2022>{{cite journal |last1=Pardo |first1=Salvatore |last2=Perera |first2=Thomas B. |title=Scarlet Fever |journal=StatPearls |date=2022 |pmid=29939666 |url=https://pubmed.ncbi.nlm.nih.gov/29939666/ |publisher=StatPearls Publishing |access-date=17 December 2022 |archive-date=23 March 2022 |archive-url=https://web.archive.org/web/20220323045123/https://pubmed.ncbi.nlm.nih.gov/29939666/ |url-status=live }}</ref> These are lines of [[petechia]]e, appearing as pink/red areas located in arm pits and elbow pits.<ref name=Goldman2020/> It takes around a week for the main rash to disappear.<ref name=CDC2022/> This may be followed by several weeks of peeling of the skin of typically fingers and toes.<ref name=CDC2022/> The desquamation process usually begins on the face and progresses downward on the body.<ref name=Zitelli2023/> Sometimes, this peeling is the only sign that scarlet fever occurred.<ref name=Andrew2020/> If the case of scarlet fever is uncomplicated, recovery from the fever and clinical symptoms, other than the process of desquamation, occurs in 5–10 days.<ref name=Marks2013/> After the desquamation, the skin will be left with a sunburned appearance.<ref name=Nelson2016>{{Cite book|title=Nelson Textbook of Pediatrics|last1=Kliegman|first1=Robert|last2=Stanton|first2=Bonita|last3=St Geme|first3=Joseph|last4=Schor|first4=Nina|publisher=Elsevier|year=2016|pages=1327–1337}}</ref>