Scarlet Fever (for Parents) – Nemours Kidshealth

What Is Scarlet Fever?

Scarlet fever (also known as scarlatina) is an illness that can happen in kids who also have strep throat or strep skin infections. The strep bacteria make a toxin (poison) that causes a bright red, bumpy rash.

The rash spreads over most of the body and is what gives scarlet fever its name. It often looks like a bad sunburn with fine bumps that may feel rough like sandpaper, and it can itch. It usually starts to go away after about 6 days, but might peel for several weeks as the skin heals.

If your child has a rash like this, it’s important to call your doctor. Kids with scarlet fever can be treated with antibiotics.

What Are the Symptoms of Scarlet Fever?

The telltale rash is the main sign of scarlet fever. It usually starts on the neck and face, often leaving a clear area around the mouth. It spreads to the chest and back, then to the rest of the body. In body creases, especially around the underarms, elbows, and groin, the rash forms red streaks.

Other symptoms of scarlet fever include:

• a red, sore throat
• a fever above 101°F (38.3°C)
• swollen glands in the neck

Also, the tonsils and back of the throat might be covered with a whitish coating, or look red, swollen, and dotted with whitish or yellowish specks of pus. Early in the infection, the tongue may have a whitish or yellowish coating. A child with scarlet fever also may have chills, body aches, nausea, vomiting, and loss of appetite.

In rare cases, scarlet fever may develop from a streptococcal skin infection like impetigo. In these cases, the child may not get a sore throat.

How Is Scarlet Fever Diagnosed?

To confirm whether a child has scarlet fever, doctors usually order a rapid strep test or throat culture (a painless swab of the throat) to check for the strep bacteria.

How Is Scarlet Fever Treated?

If a strep infection is confirmed, the doctor will prescribe an antibiotic for a child to take for about 10 days. That usually will cure the infection itself, but it may take a few weeks for the tonsils and swollen glands to return to normal.

How Can I Help My Child?

Eating can be painful for kids with severe strep throat, so serving soft foods or a liquid diet may be best. Include soothing teas and warm nutritious soups, or cool drinks, popsicles, or slushies. Make sure that your child drinks plenty of fluids. You can give over-the-counter acetaminophen or ibuprofen for fever or throat pain.

If the rash itches, make sure that your child’s fingernails are trimmed short so skin isn’t damaged through scratching. Try an over-the-counter anti-itch medicine to help relieve the itching.

Can Scarlet Fever Be Prevented?

The bacterial infection that causes scarlet fever is contagious. Kids with scarlet fever can spread the bacteria to others through sneezing and coughing. A skin infection caused by strep bacteria, like impetigo, can be passed through contact with the skin.

When a child is sick at home, it’s always safest to keep his or her toothbrush, drinking glasses, and eating utensils separate from those of other family members, and to wash these items well in hot soapy water. Wash your own hands often as you care for a child with a strep infection.

When Should I Call the Doctor?

Call the doctor whenever your child suddenly develops a rash, especially if he or she also has a fever, sore throat, or swollen glands. This is especially important if your child has any of the symptoms of strep throat, or if someone in your family or at your child’s daycare or school recently had a strep infection.

8 Signs You Have Strep

Lots of things can cause a sore through. One cause, especially in children and young adults, is the bacteria that creates strep throat. Streptococcus pyogenes (group A Streptococcus) is the formal name of the bacterium.

Viruses can cause a sore throat too, including:

Other things that might cause your sore throat include:

• Allergies

• Dry air

• GERD (gastroesophageal reflux disease)

• HIV

• Irritants, like tobacco smoke or eating spicy food

• Muscle strain from talking loudly or for a long time, and yelling

• Tumors

What Are the Common Symptoms of Strep Throat?

When you have strep, you’ll usually find that your throat is raw and it hurts to swallow. Your sore throat, if it’s caused by strep, will come on very fast, not gradually like many other kinds of sore throats. Other symptoms often include:

• A fever of 101 F or higher

• Chills

• Body aches

• Loss of appetite

• Swollen lymph nodes on your neck

• Really little red spots on the back part of the roof of your mouth

• Red and swollen tonsils (two round lumps in the back of your throat — you may also see white patches on them or elsewhere in your throat)

• Trouble swallowing

• Pain in your throat

Symptoms in children

Strep throat is more common with kids than adults, and it’s most common with children who are 5-15 years old. If your child has strep throat, they might also have symptoms like:

You might also see a red, sandpaper-like rash that starts in the face and neck area and then spreads to the rest of the body. This could be a sign of scarlet fever. You should call your doctor if you or a child in your care show any symptoms of strep or you see this rash.

What Strep Throat Isn’t

It’s easy to confuse it with other conditions, so it helps to know what it’s not:

It’s not a virus — viruses can’t be cured with antibiotics.

It usually doesn’t come with a runny nose, a cough, or red eyes. These are usually signs of a virus or allergy.

It’s not life-threatening. But if you leave it untreated, strep throat can lead to more serious complications in some cases.

Strep Throat Transmission

The bacteria that cause strep are highly contagious. You can spread it by close contact — including sneezes and handshakes — or sharing someone else’s personal items.

Be sure to wash your hands often and be cautious about touching objects when someone in your house has strep.

Scarlet Fever in an Infant or a Baby: Condition, Treatments, and Pictures for Parents – Overview

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Images of Scarlet Fever (Scarlatina)

Overview

Scarlet fever is a contagious infection of the upper respiratory tract (mostly the throat) that characteristically has a red, sandpaper-like rash. The infection is caused by a poison (toxin) produced by a bacterium called group A streptococcus. The rash appears 1–2 days after onset of symptoms (ie, sore throat and fever) and starts on the neck and spreads downward on the body. The rash generally covers all of the skin on the body with the exception of the face. Applying pressure to the rash will cause the skin to turn white. After 3–4 days, the rash begins to fade, and sometimes the skin peels when the rash disappears, similar to sunburn.

Who’s at risk?

Scarlet fever is encountered much less frequently today than it was in the past, and it is very rare in infants, as they are protected by their mother’s immune system components that prevent infection (antibodies) given to them at birth. Scarlet fever occurs in cycles in the population, depending on the strength of the bacterium. It is spread by fluids from the airways (ie, cough, saliva, mucus).

Signs and Symptoms

A sandpaper-like rash of 1–2 mm, red bumps, which merge together, starting on the neck, and then move to the trunk and finally to the arms and legs (extremities). The rash of scarlet fever can be slightly itchy. If it develops on body creases (armpits, elbow folds), red streaks may appear.

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

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.

Self-Care Guidelines

With scarlet fever, it is difficult to avoid infection of others in the household who are not immune to the infection. However, you might try to:

• Keep eating and clothing items used by an ill child away from other people, and wash them in hot soapy water.
• The child’s caregivers should wash their hands frequently.
• Keep the child comfortable with acetaminophen (Tylenol®) or ibuprofen for fever relief.
• Have your child eat soft foods, drink plenty of liquids, and apply lotions such as calamine for itching, if needed.

When to Seek Medical Care

Call your child’s doctor if you suspect that the child may have scarlet fever.

Treatments Your Physician May Prescribe

The doctor will usually do a throat or skin culture or a rapid strep test to confirm the child’s diagnosis. If strep infection is confirmed, prescription antibiotics will be prescribed, to be taken for about 10 days.

Trusted Links

MedlinePlus: Streptococcal InfectionsClinical Information and Differential Diagnosis of Scarlet Fever (Scarlatina)

References

Bolognia, Jean L., ed. Dermatology, pp.1119-1120. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick’s Dermatology in General Medicine. 6^th ed. pp.1871-1873. New York: McGraw-Hill, 2003.

Scarlet fever – Illnesses & conditions

Scarlet fever is a bacterial illness that mainly affects children. It causes a distinctive pink-red rash.

The illness is caused by Streptococcus pyogenes bacteria, also known as group A streptococcus, which are found on the skin and in the throat.

Generally, scarlet fever is much less common than it used to be but in recent years there have been a number of significant outbreaks.

For example, figures published by Public Health England show that from September 2013 to March 2014 there were 2,830 cases of scarlet fever. For the same period in 2014/15 a total of 5,746 cases were recorded. The reason for recent increase is unclear.

It’s important to be aware of the signs and symptoms of scarlet fever so that early treatment with antibiotics can be given.

Scarlet fever symptoms

Scarlet fever usually follows a sore throat or a skin infection, such as impetigo, caused by particular strains of streptococcus bacteria.

Initial symptoms usually include a sore throat, headache and a high temperature (38.3C/101F or above), flushed cheeks and a swollen tongue.

A day or two later the characteristic pinkish rash appears. It usually occurs on the chest and stomach before spreading to other areas of the body, such as the ears and neck.

The symptoms of scarlet fever usually develop two to five days after infection, although the incubation period (the period between exposure to the infection and symptoms appearing) can be as short as one day or as long as seven days.

The rash feels like sandpaper to touch and it may be itchy. On darker skin the rash may be more difficult to see although its rough texture should be apparent.

When to seek medical advice

Scarlet fever usually clears up after about a week, but if you think you or your child may have it, see your GP for a proper diagnosis and appropriate treatment.

Your GP should be able to diagnose scarlet fever by examining the distinctive rash and asking about other symptoms. They may also decide to take a sample of saliva from the back of the throat so it can be tested in a laboratory to confirm the diagnosis.

There’s no evidence to suggest that catching scarlet fever when pregnant will put your baby at risk. However, if you’re heavily pregnant, tell the doctors and midwives in charge of your care if you’ve been in contact with someone who has scarlet fever.

How scarlet fever spreads

Scarlet fever is very contagious and can be caught by:

• breathing in bacteria in airborne droplets from an infected person’s coughs and sneezes
• touching the skin of a person with a streptococcal skin infection, such as impetigo
• sharing contaminated towels, baths, clothes or bed linen

It can also be caught from carriers – people who have the bacteria in their throat or on their skin but don’t have any symptoms.

Who’s affected by scarlet fever

Most cases (about 80%) of scarlet fever occur in children under 10 (usually between two and eight years of age). However, people of any age can get the illness.

As it’s so contagious, scarlet fever is likely to affect someone in close contact with a person with a sore throat or skin infection caused by streptococcus bacteria. Outbreaks often occur in nurseries and schools where children are in close contact with one another.

The symptoms of scarlet fever will only develop in people susceptible to toxins produced by the streptococcus bacteria. Most children over 10 years of age will have developed immunity to these toxins.

It’s possible to catch scarlet fever more than once, but this is rare.

Treating scarlet fever

Scarlet fever used to be a very serious illness, but nowadays most cases tend to be mild.

It can easily be treated with antibiotics. Liquid antibiotics, such as penicillin or amoxicillin, are often used to treat children. These must be taken for 10 days, even though most people recover after four to five days.

It’s important to be aware that your child will still be infectious for 24 hours after antibiotic treatment has begun, and therefore they shouldn’t attend nursery or school during this period (see below).

Without antibiotic treatment, your child will be infectious for 1-2 weeks after symptoms appear.

Read more about treating scarlet fever.

Complications of scarlet fever

With the right treatment, further problems are unlikely. However, there’s a small risk of the infection spreading to other parts of the body and causing more serious infections, such as an ear infection, sinusitis, or pneumonia.

Read more about complications of scarlet fever.

Preventing scarlet fever from spreading

There’s currently no vaccine for scarlet fever.

If your child has scarlet fever, keep them away from nursery or school for at least 24 hours after starting treatment with antibiotics. Adults with the illness should also stay off work for at least 24 hours after starting treatment.

GPs, schools and nurseries should be aware of the current high levels of scarlet fever and inform local health protection teams if they become aware of cases, particularly if more than one child is affected.

Children and adults should cover their mouth and nose with a tissue when they cough or sneeze and wash their hands with soap and water after using or disposing of tissues.

Avoid sharing contaminated utensils, cups and glasses, clothes, baths, bed linen or towels.

Scarlet fever – NHS

Scarlet fever is a contagious infection that mostly affects young children. It’s easily treated with antibiotics.

Check if you have scarlet fever

The first signs of scarlet fever can be flu-like symptoms, including a high temperature, a sore throat and swollen neck glands (a large lump on the side of your neck).

A rash appears 12 to 48 hours later. It looks looks like small, raised bumps and starts on the chest and tummy, then spreads. The rash makes your skin feel rough, like sandpaper.

On white skin the rash looks pink or red. It may be harder to see on brown and black skin, but you can still feel it.

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A white coating also appears on the tongue. This peels, leaving the tongue red, swollen and covered in little bumps (called “strawberry tongue”).

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The rash does not appear on the face, but the cheeks can look red. The redness may be harder to see on brown and black skin..

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The symptoms are the same for children and adults, although scarlet fever is less common in adults.

Non-urgent advice: See a GP if you or your child:

• have scarlet fever symptoms
• do not get better in a week (after seeing a GP)
• have scarlet fever and chickenpox at the same time
• are ill again, weeks after scarlet fever got better – this can be a sign of a complication, such as rheumatic fever
• are feeling unwell and have been in contact with someone who has scarlet fever

Scarlet fever is very easily spread. Check with a GP before you go in. They may suggest a phone consultation.

Information:

Coronavirus (COVID-19) update: how to contact a GP

It’s still important to get help from a GP if you need it. To contact your GP surgery:

• visit their website
• use the NHS App
• call them

Find out about using the NHS during COVID-19

What happens at your appointment

GPs can often diagnose scarlet fever by looking at your tongue and rash.

Sometimes they may:

• wipe a cotton bud around the back of your throat to test for bacteria
• arrange a blood test

Treating scarlet fever

A GP will prescribe antibiotics. These will:

• help you get better quicker
• reduce the chance of a serious illnesses, such as pneumonia
• make it less likely that you’ll pass the infection on to someone else

Taking antibiotics

Keep taking the antibiotics until they’re finished, even if you feel better.

Things you can do yourself

You can relieve symptoms of scarlet fever by:

• drinking cool fluids
• eating soft foods if you have a sore throat
• taking painkillers like paracetamol to bring down a high temperature (do not give aspirin to children under 16)
• using calamine lotion or antihistamine tablets to ease itching

How long scarlet fever lasts

Scarlet fever lasts for around 1 week.

You can spread scarlet fever to other people up to 6 days before you get symptoms until 24 hours after you take your 1st dose of antibiotics.

If you do not take antibiotics, you can spread the infection for 2 to 3 weeks after your symptoms start.

Important

If you or your child has scarlet fever, stay away from nursery, school or work for 24 hours after you take the 1st dose of antibiotics.

Is scarlet fever dangerous?

Scarlet fever can be a serious illness, but thanks to antibiotics, it’s less common than it used to be and easier to treat.

But cases of scarlet fever have increased in recent years. Public Health England records the number of scarlet fever infections each year.

Complications from scarlet fever are rare. They can happen during or in the weeks after the infection, and can include:

Pregnancy advice

There’s no evidence to suggest that getting scarlet fever during pregnancy will harm your baby.

But it can make you feel unwell, so it’s best to avoid close contact with anyone who has it.

Contact a GP if you get symptoms.

Many of the antibiotics used for scarlet fever are considered to be safe to take during pregnancy.

How to avoid spreading scarlet fever

Scarlet fever is very infectious and can easily spread to other people.

To reduce the chance of spreading scarlet fever:

Do

• wash your hands often with soap and water

• use tissues to trap germs from coughs or sneezes

• bin used tissues as quickly as possible

Don’t

• do not share cutlery, cups, towels, clothes, bedding or baths with anyone who has symptoms of scarlet fever

Page last reviewed: 29 June 2021
Next review due: 29 June 2024

Scarlet Fever – StatPearls – NCBI Bookshelf

Continuing Education Activity

Scarlet fever is a blanching, papular rash, commonly described as a sandpaper rash. It is usually associated with Streptococcus pyogenes pharyngitis in school-age and adolescent children. The first-line treatment is penicillin, though a first-generation cephalosporin can be used in patients who are allergic to penicillin. This activity illustrates the evaluation and treatment of scarlet fever and highlights the role of the interprofessional team in preventing complications in those with this condition.

Objectives:

• Explain the etiology of scarlet fever.

• Review the treatment of streptococcal pyogenes infections.

• Summarize the potential complications of untreated streptococcal pyogenes infections.

• Outline interprofessional team sessions to practice using the “teach-back” method, which can help ensure patients know how to take antibiotics in the manner prescribed for treatment of streptococcal pyogenes infections and to ensure recognition of the importance of complying with the antibiotic regimen in order to enhance outcomes for patients with scarlet fever.

Access free multiple choice questions on this topic.

Introduction

Scarlet fever is a rash most commonly associated with bacterial pharyngitis in school-age and adolescent children. It is a blanching, papular rash that is classically described as a “sandpaper” rash. The causative bacteria is Streptococcus pyogenes, which generates an endotoxin mainly responsible for the skin manifestation of the infection. This is further classified as group A and referred to as Group A Strep (GAS). Alone, the rash is not dangerous but is a marker for GAS infection which has suppurative and non-suppurative complications. Therefore, treatment of the acute infection is warranted to prevent these complications. The first-line treatment of choice is penicillin. Those allergic to penicillin can be treated with a first-generation cephalosporin. The spread of infection is promoted by mucosal transfer of bacteria to others via an environment of close proximity found in classrooms and similar workplace settings.[1][2][3]

Etiology

The causative agent in scarlet fever is GAS, a gram-positive coccus that grows in chains. Scarlet fever is caused by the release of endotoxins. The bacteria also is classified as a beta hemolytic strep which can cause complete red cell destruction (GABHS). The bacteria is the causative agent of strep throat, impetigo, erysipelas, cellulitis, and necrotizing fasciitis.[4]

Epidemiology

Scarlet fever is a disease of childhood due to ease of transmission in the classrooms and nurseries. It is most commonly associated with bacterial pharyngitis caused by GAS or strep throat. Wounds and burns infected with GAS also can cause scarlet fever. It has been reported that strep throat is the responsible for 15% to 30% of all pharyngitis in children aged 5 to 15 years old. In adults, the rate is 5% to 15%.  Non-school-aged children in contact with school-aged children in the same household are also at risk. There is no gender preference for scarlet fever.  [3][5][6]

Multiple studies have reported the emergence of scarlet fever coinciding with the initiation of the school year and the colder temperatures as winter approaches. A decrease in the rate of infection can be attributed to times when school is not in session during the spring and warming temperatures. The difference in rates between children and adults is likely due to the presence or absence of immunity. The prevalence is higher in undeveloped countries. This is probably due to the more likely presence of crowded living quarters. An article on the epidemiology of scarlet fever in Hong Kong reported an increase in the incidence of disease from 3.3/10,000 to 18.1/10,000. Similar increases have been reported in Great Britain. The increase has not been explained, but resistant strains of GAS are suspected.

Pathophysiology

Scarlet fever is a rash resulting from an infection caused by GAS. The exotoxin produced by the bacteria causes the classic “sandpaper” rash.  The toxins cause a local inflammatory response on the skin and are referred to as erythrogenic toxins. 

Histopathology

There are no specific histological changes in scarlet fever. One will observe neutrophilic infiltrate with spongiosis and parakeratosis in the epidermis. 

History and Physical

Typically, scarlet fever is associated with an acute pharyngitis. As a result, fever, sore throat, pain with swallowing, and cervical adenopathy is present. If there is no pharyngitis, the source of infection can be a wound or burn which is infected with GAS. The two vectors of infection can both cause scarlet fever and are not distinguishable from one another. The rash itself is a blanching, papular rash. It is distinguished from the macular rash found an allergic reaction by its insidious emergence and lack of confluence of the lesions. This lack of confluence is the primary reason it feels like sandpaper. Also of note, there are no vesicles or pustules present. Vesicles are more associated with the “dew on a rose petal” appearance of chicken pox in its initial stages. Pustules are more indicative of a local infection such as impetigo or erysipelas. The rash develops within 2 to 3 days after infection but can be delayed up to 7 days. The trunk, underarms, and groin are affected first, and then it spreads to the extremities. Usually, the palms and soles are spared. The circumoral area is also spared, making it pallor-like. The “strawberry tongue” begins with a white coating of the tongue with hyperplastic papillae. As the white coating resolves, the papules remain, giving the appearance of a strawberry. Pastia lines are found in the folds of the skin such as the neck, antecubital fossa, and groin. This appears as a linear accumulation of papules around pressure points. After the initial rash begins to resolve, a period of desquamation can occur and last up to two weeks in some cases. 

Evaluation

When evaluating a person suspected of having scarlet fever, there are several things to consider. After carefully taking a history and physical, the next steps of the evaluation can be considered. In cases associated with pharyngitis, lack of a cough, exudates, cervical nodes, temperature, and age (less than 15 years) help determine the likelihood of strep throat. This is known as the CENTOR criterion.[7][8][9]

Testing available to the clinician includes throat culture and the rapid strep test. Both test for the presence of GAS. The throat culture takes longer (days) and is more specific, and the rapid test is immediate (minutes) and less specific. The use of the rapid strep test with older persons (greater than 45 years) is controversial since they are more likely to be a carrier state and have lower prevalence in that age group. This combination may increase exposure to inappropriate antibiotics and increased resistance.

Therefore, in young patients with a high CENTOR score, rapid strep is recommended to confirm the infection and treatment is initiated. Depending on your practice environment and follow up, your decision to treat may be influenced. 

Treatment / Management

Since scarlet fever is due to an infection caused by GAS, it is treated with antibiotics. Penicillin or amoxicillin is the first-line treatment. If the affected person has an allergy to penicillin, a first-generation cephalosporin can be used. The use of antibiotics has reduced the morbidity and mortality of scarlet fever when compared to the early 20th century when the mortality was approximately 30%. [10][11][12]

GAS has its reservoir in the nasal mucosa, adenoids, tonsils. Asymptomatic individuals who test positive for GAS are generally referred to as carriers. Current practice deters treatment of carriers with antibiotics.

Differential Diagnosis

The differential diagnosis of a fever and a rash are broad. In the clinical scenario of a sandpaper rash in the presence of a sore throat and fever, GAS infection should be seriously considered. Use of the CENTOR criteria and testing can be utilized. Pustules are more indicative of a local infection such as impetigo or erysipelas. Some viral illnesses which should be considered in the affected population are measles (rubeola), chicken pox (herpes zoster), and hand-foot-and-mouth disease (Coxsackie), which all have specific presentations that distinguish them from scarlet fever. Good immunization, travel, and medical history should be considered when a patient presents with fever and a rash.

Prognosis

When compared to the prognosis of scarlet fever in the early 20 century, the prognosis of scarlet fever is excellent. This mainly due to the introduction of antibiotics and hygiene. After the diagnosis is made and treatment is initiated, the patient can return to normal activity 24 hours after the fever has resolved. Left untreated, the prognosis decreases and the likelihood of complications stemming from group A strep infection increases. Suppurative and non-suppurative complications abscess near the local area of infection to kidney injury.

Complications

Historically, scarlet fever was a disease with a high complication rate and even death among children. With the development of antibiotics and treatment regimens, scarlet fever is now considered a relatively mild disease. However, complications from delayed or untreated GAS are significant. The complications fall into two categories, suppurative and non-suppurative. Typically, suppurative complications result from a worsening, an extension, or a spread of the original area of infection. As an example, a bacterial pharyngitis can spread to the ear, causing otitis media; the sinuses, causing a sinusitis; and then to the meninges, causing bacterial meningitis. Non-suppurative complications generally are mediated through an immune response after the original infection resolves. Rheumatic fever, a disease affecting the heart valves, is a complication of GAS infection that results in long-term morbidity.

Although not directly caused by scarlet fever, below is a partial list of complications due to GAS infection.

Suppurative

• Peritonsillar/pharyngeal abscess

• Otitis media

• Sinusitis

• Necrotizing fasciitis

• Streptococcal bacteremia

• Meningitis or brain abscess

• Jugular vein septic thrombophlebitis 

Non-Suppurative

• Acute rheumatic fever

• Poststreptococcal reactive arthritis

• Streptococcal toxic shock syndrome

• Acute glomerulonephritis

• Pediatric autoimmune neuropsychiatric disorder associated with group A streptococci

Deterrence and Patient Education

Scarlet fever and most diseases which are transmitted via close contact can be avoided by using good hand hygiene, covering your coughs and sneezes, regular disinfection of shared fomites, and avoiding others when infected. Reminders in public areas in the form of posters and public service announcements in the media are some of the ways to increase these good hygiene practices. The public also should be aware of the risks associated with the overuse of antibiotic administration which may introduce resistant strains of GAS. 

Enhancing Healthcare Team Outcomes

Scarlet fever is best managed by an interprofessional team. The key to treatment is patient education. The pharmacist should emphasize to the patient that full recovery occurs when antibiotic compliance is complete. In addition, the nurse should educate the patient on hand and personal hygiene to prevent transmission of the bacteria to others. Patients should be educated about the skin infection and the general exfoliation, and when to seek medical assistance. The skin symptoms are frequently relieved with the use of emollients and oral antihistamines.[13][14] (Level V)

Outcomes

For the majority of patients treated promptly, the outcome is excellent. Recovery is usually complete in 3-6 days but the skin symptoms may take 14-21 days to subside. In a few people, the infection can recur. In the era of antibiotics, mortality from scarlet fever is less than 1%. The morbidity of scarlet fever is most likely due to glomerulonephritis, rheumatic fever, sinusitis, and other infections. Complications, though, are rare.[15][2] (Level V)

Figure

The fine, red, itchy rash caused by scarlet fever. This is my six-year-old daughter, Lexie, displaying the rash. Contributed by Wikimedia Commons, Alicia Williams (CC by 2.5) https://creativecommons.org/licenses/by/2.5/deed.en

References

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2.

Yung CF, Thoon KC. A 12 year outbreak of scarlet fever in Singapore. Lancet Infect Dis. 2018 Sep;18(9):942. [PubMed: 30152353]

3.

Barnett TC, Bowen AC, Carapetis JR. The fall and rise of Group A Streptococcus diseases. Epidemiol Infect. 2018 Aug 15;:1-6. [PMC free article: PMC6518539] [PubMed: 30109840]

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Brockmann SO, Eichner L, Eichner M. Constantly high incidence of scarlet fever in Germany. Lancet Infect Dis. 2018 May;18(5):499-500. [PubMed: 29695362]

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Zhang Q, Liu W, Ma W, Zhang L, Shi Y, Wu Y, Zhu Y, Zhou M. Impact of meteorological factors on scarlet fever in Jiangsu province, China. Public Health. 2018 Aug;161:59-66. [PubMed: 29909092]

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Lee CF, Cowling BJ, Lau EHY. Epidemiology of Reemerging Scarlet Fever, Hong Kong, 2005-2015. Emerg Infect Dis. 2017 Oct;23(10):1707-1710. [PMC free article: PMC5621532] [PubMed: 28930009]

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Managing scarlet fever. Drug Ther Bull. 2017 Sep;55(9):102. [PubMed: 28882851]

8.

Chalker V, Jironkin A, Coelho J, Al-Shahib A, Platt S, Kapatai G, Daniel R, Dhami C, Laranjeira M, Chambers T, Guy R, Lamagni T, Harrison T, Chand M, Johnson AP, Underwood A., Scarlet Fever Incident Management Team. Genome analysis following a national increase in Scarlet Fever in England 2014. BMC Genomics. 2017 Mar 10;18(1):224. [PMC free article: PMC5345146] [PubMed: 28283023]

9.

Wessels MR. Pharyngitis and Scarlet Fever. In: Ferretti JJ, Stevens DL, Fischetti VA, editors. Streptococcus pyogenes
: Basic Biology to Clinical Manifestations [Internet]. University of Oklahoma Health Sciences Center; Oklahoma City (OK): Feb 10, 2016. [PubMed: 26866221]

10.

Hübner J, Jansson A. [Scarlet fever]. MMW Fortschr Med. 2012 Oct 18;154(18):57-8. [PubMed: 23156877]

11.

Lamden KH. An outbreak of scarlet fever in a primary school. Arch Dis Child. 2011 Apr;96(4):394-7. [PubMed: 21068078]

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Hedrick J. Acute bacterial skin infections in pediatric medicine: current issues in presentation and treatment. Paediatr Drugs. 2003;5 Suppl 1:35-46. [PubMed: 14632104]

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Salerno J. Pediatric management problems. What is your assessment? Scarlet fever. Pediatr Nurs. 1996 Mar-Apr;22(2):152-3. [PubMed: 8715851]

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Radikas R, Connolly C. Young patients in a young nation: scarlet fever in early nineteenth century rural New England. Pediatr Nurs. 2007 Jan-Feb;33(1):53-5. [PubMed: 17411002]

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Wang HC, Lau CI, Lin CC, Chang A, Kao CH. Group A Streptococcal Infections Are Associated With Increased Risk of Pediatric Neuropsychiatric Disorders: A Taiwanese Population-Based Cohort Study. J Clin Psychiatry. 2016 Jul;77(7):e848-54. [PubMed: 27464318]

Scarlet fever | DermNet NZ

Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, 2002. Updated September 2015.

What is scarlet fever?

Scarlet fever is a bacterial illness that often presents with a distinctive rash made up of tiny pinkish-red spots that cover the whole body. It affects people who have recently had a sore throat (strep throat) or school sores (impetigo) caused by certain strains of the group A streptococcus bacteria. A toxin released by the streptococcal bacteria causes the rash of scarlet fever.

Scarlet fever has also been called scarlatina in the past.

How common is scarlet fever and who gets it?

Scarlet fever is not as common as it was a century ago when it was associated with deadly epidemics. The development of antibiotics and their early use in the treatment of streptococcal infections has prevented many cases of scarlet fever and the long-term complication of rheumatic fever.

Scarlet fever occurs mostly in children aged 4-8 years. By 10 years old, up to 80% of children have developed lifelong protective antibodies against streptococcal toxins, whilst children younger than 2 years still have acquired maternal antiexotoxin antibodies. Males and females are affected equally.

How do you get scarlet fever?

Group A streptococcal infections that cause scarlet fever are contagious. Streptococcal bacteria can spread from person to person by breathing in airborne droplets from an infected person’s coughing or sneezing. Bacteria can also be passed by touching the infected skin of someone with a streptococcal skin infection, or by sharing contaminated clothes, towels or bed linen.

Scarlet fever can also be spread by infected individuals who are carriers of streptococcal bacteria but do not show any symptoms. Up to 15-20% of school-age children are thought to be asymptomatic carriers.

To get scarlet fever you must still be susceptible to the toxin produced by the streptococcal bacteria. Therefore, it can happen that 2 children of the same family may both have streptococcal infections, but only one (who is still susceptible to the toxin) develops scarlet fever.

Scarlet fever generally has a 1–4 day incubation period.

Who is at risk of scarlet fever?

Those at greatest risk for scarlet fever include:

• People living in overcrowded environment such as boarding schools, day care or military camps
• Children older than 3 years
• People in close contact with someone who has a strep throat or skin infection

What are the signs and symptoms of scarlet fever?

Scarlet fever usually starts with a sudden fever associated with sore throat, swollen neck glands, headache, nausea, vomiting, loss of appetite, swollen and red strawberry tongue, abdominal pain, body aches, and malaise.

The characteristic rash appears 12–48 hours after the start of the fever. The rash usually starts below the ears, neck, chest, armpits and groin before spreading to the rest of the body over 24 hours.

Scarlet spots or blotches, giving a boiled lobster appearance, are often the first sign of rash.

As skin lesions progress and become more widespread, they start to look like sunburn with goose pimples. The skin may have a rough sandpaper-like feel.

In body folds, especially the armpits and elbows, fragile blood vessels (capillaries) can rupture and cause classic red streaks called Pastia lines. These may persist for 1-2 days after the generalised rash has gone.

In the untreated patient, the fever peaks by the second day and gradually returns to normal in 5–7 days. When treated with appropriate antibiotics, the fever usually resolves within 12-24 hours.

By about the sixth day of the infection the rash starts to fade and peeling, similar to that of sunburned skin, occurs. Peeling of the skin is most prominent in the armpits, groin, and tips of the fingers and/or toes and may continue up to 6 weeks.

Scarlet fever

How is scarlet fever diagnosed?

Diagnosis of scarlet fever is often suspected from the characteristic history and physical examination. Diagnosis is supported by:

• Throat swab culture or rapid streptococcal antigen test, taken from posterior pharynx or tonsils
• Anti-dexoyribonuclease B and antistreptolysin-O titres

What is the treatment of scarlet fever?

Once a streptococcal infection is confirmed, a course of antibiotics is prescribed, usually penicillin, for up to 10 days. It is very important that the full antibiotic course is taken to ensure all the infection is cleared, to reduce the risk of complications.

In some situations a single dose of penicillin may be given by intramuscular injection. Patients allergic to penicillin may be treated with an alternative antibiotic, such as erythromycin.

Additional treatments include:

• Paracetamol when necessary for fever, headache or throat pain.
• Eating soft foods and drinking plenty of cool liquids, particularly if the throat is very painful.
• Oral antihistamines and emollients to relieve the itch of rash.
• Keep fingernails short on young children to prevent them from damaging the skin.

The fever usually improves within 12-24 hours after starting antibiotics and most patients recover after 4-5 days with clearing of skin symptoms over several weeks.

What are the complications from scarlet fever?

Nowadays, scarlet fever infection usually follows a benign course when diagnosed and treated appropriately. However, if left untreated or treatment is unsuccessful, the following complications caused by the streptococcal infection may arise.

• Rheumatic fever
• Otitis media
• Pneumonia
• Septicaemia
• Glomerulonephritis
• Osteomyelitis
• Death

Rheumatic fever, which affects the heart, and glomerulonephritis, which affects the kidneys, may permanently damage the body and require long-term treatment.

How to prevent scarlet fever

To prevent spread of streptococcus bacteria that cause scarlet fever, an infected individual should ideally be isolated from other family members, especially from infants and younger siblings. To help prevent spread, keep drinking glasses and eating utensils used by the infected individual separate from those of other family members. These items need to be washed thoroughly in very hot soapy water, preferably with antibacterial soap or detergent.

Children should be kept away from school until they have received at least 24 hours of antibiotic therapy and there are clear signs of improvement.

Streptoderma | “Dermatovenerologic dispensary No. 6”

Streptoderma (streptococcal pyoderma) – is an infectious and allergic disease.

The disease occurs when streptococcus and its waste products enter the skin.

The main manifestation of the disease , regardless of the patient’s age, is the formation of purulent elements on the surface of the skin, which have a characteristic rounded shape and flaky surface.Distinguish between clinical forms of the disease, depending on the size of the pathological focus, their number and area of ​​distribution.

Causes of streptoderma

The causative agents of the disease – microorganisms of the streptococcus family, are typical representatives of the conditionally pathogenic microbial flora of the body – with sufficiently intense local immunity, the integrity of the skin and mucous membranes, the normal functioning of the body’s immune system as a whole, the active development and spread of this organism is limited, and the disease does not develop.

The emergence of streptoderma is always associated with a violation of the integrity of the skin (microtrauma or abrasion is enough for the infection to penetrate), a change in local immunity and a violation of the activity of the immune system of the body as a whole.

Causes and risk factors for the development of streptoderma

With this disease, as with any streptococcal infection, there is a incubation period. When streptococcus enters the body, the typical clinical picture of streptoderma develops only 7 days after infection .

After the end of the incubation period, conflicts appear on the skin . These specific skin rashes are the hallmark of streptoderma.

Predisposing factors, the presence of which increases the likelihood of developing the disease, are:

• disregard for the rules of personal hygiene;
• acute and chronic fatigue;

90,041 stressful situations;

• any conditions that can cause a decrease in immunity;
• insufficient amount of vitamins in the patient’s food and his body;

90,041 skin injuries (even the smallest).

A microorganism can enter the human body through household contact – the infection is transmitted through dishes, clothes, through household contacts, through toys, as well as through dust, which contains streptococci.

In the hot season the infection can be transmitted by insects, which carry pathogens on their paws.

In the cold season , a seasonal increase in the incidence of streptoderma is very often observed, coinciding in time with an increase in the incidence of scarlet fever and tonsillitis – this situation is explained by the fact that the cause of all diseases is the same microorganism.

Cynical symptoms and localization of streptoderma

The main manifestations of the disease become:

• The appearance on the surface of the skin of small vesicles filled with a clear, but quickly cloudy liquid.
• Most often, the rash is localized on the face, back, limbs, lower body.
• Skin itching (unbearable burning sensation often occurs).
• Pigmentation of the skin at the site of the “old” foci of the disease.
• General malaise – impaired well-being, lethargy, weakness, lack of appetite.

Depending on the location of the rash, there are several clinical forms of streptoderma:

• streptococcal impetigo – is manifested by single scattered rashes (conflicts), which are localized on the skin of the face, trunk, limbs, tend to merge. The lesions do not penetrate deeper than the basal layer of the skin, after opening the fliken, thin gray crusts are formed on the skin surface, leaving bluish-pink spots after falling off;
• bullous impetigo – is manifested by large conflicts, after opening which surface erosions open on the skin, prone to an increase in the surface of the lesion.Such elements are most often formed on the hands, feet and legs;
• streptococcal seizure (angular stomatitis, slit impetigo) – is manifested by conflicts located in the corners of the mouth. The primary element of the rash very quickly turns into linear cracks, covered with honey-yellow crusts, falling off without a trace, but prone to reappearance. In addition, slit-like impetigo can appear at the wings of the nose or near the outer edge of the palpebral fissure.The disease may be accompanied by severe itching and salivation, which provoke the spread of the infectious process on the skin of the face, refusal to eat due to the inability to open the mouth;
• streptococcal lichen in children – occurs most often on the skin of the face. Scaly foci of pink or white color appear, having a rounded shape and clearly delineated borders. The elements of the rash can be reduced by exposure to sunlight, but previously affected areas of the skin cannot normally tan;
• tournament (streptoderma of nail folds) – often occurs in children who are used to biting nails.In this case, conflicts arise around the nail plates, which open up with the formation of a horseshoe-shaped erosion;
• streptococcal diaper rash – there is a lesion of the skin folds, on which small conflicts are formed, prone to fusion. After opening, weeping surfaces of bright pink color are formed on the skin.

Prevention of streptoderma

Prevention of streptoderma is:

• in respect of personal hygiene,
• limiting contact with anyone suffering from streptococcal infection,
• timely treatment of infectious diseases.

It is very important to promptly and correctly treat any minor injuries and damage to the skin. With the affected skin areas, moisture should not be allowed to enter them, as this can contribute to the spread of the disease.

We invite you for examination and consultation at “KVD No. 6”.

Our doctors are ready to provide qualified medical care and advice on all issues of concern to you.

Our address: SPb, st.Pilyutova, 41

Working hours:
• on weekdays 9.00–20.00
• Saturday (emergency) 9.00-15.00

Reception phone: 744-2715 ✆

Diseases caused by streptococci – a directory of diseases – HealthInfo

Streptococci can be present in the respiratory tract, intestines, vagina or other organs without causing visible damage. They are sometimes found in an area of ​​inflammation (such as the throat or vagina) in a person who is a carrier and are misinterpreted as the cause of the disease.

The most common type of streptococcal infection is tonsillitis. Symptoms usually appear suddenly and include sore throat, general malaise, chills, fever, headache, nausea, vomiting, and increased heart rate. The throat is bright red, the tonsils are swollen, the lymph nodes in the neck are enlarged and painful. Children may have seizures. Before the age of 4 years, the only symptom of the disease may be a runny nose. Cough, laryngeal inflammation (laryngitis), and nasal congestion are rare with streptococcal infections; these symptoms are characteristic of diseases with a different cause (acute respiratory illness or allergic conditions).

Scarlet fever is caused by streptococcal toxins, which produce a widespread pink-red rash, usually on the abdomen, on the side of the chest, and in the folds of the skin. Other symptoms are noted, in particular the absence of a rash around the mouth, a red face, an inflamed and red tongue, and dark red stripes in the skin folds. After normalization of body temperature, the skin at the site of the rash flakes and often peels off.

Streptococci also cause several forms of skin infections, but abscesses are rare.In addition, the infection can spread under the skin, causing panniculitis, or in the skin, leading to erysipelas (erysipelas). Streptococci, by themselves or with staphylococci, can spread to the outer layers of the skin, causing itchy rashes and crusts (impetigo).

Certain strains of streptococci can cause rapidly spreading destructive lesions under the skin (necrotizing fasciitis). For reasons unknown, outbreaks of this infection have recently become more frequent.

Strep throat / scarlet fever

What is strep throat / scarlet fever?

Streptococcal sore throat and scarlet fever are different forms of bacterial disease caused by infection with group A streptococci (beta-hemolytic).

• When bacteria infects the throat, the disease is called strep throat.
• Streptococci can also produce a toxin that causes severe skin rashes. When this happens, the disease is called scarlet fever.

How do you get sore throat / scarlet fever?

• You can get streptococcus / scarlet fever through close contact with people infected with the bacteria.
• Sometimes both strep throat and scarlet fever are transmitted indirectly through contact with objects that are used by infected people or contaminated hands.
• Group A streptococci have also been associated with foodborne disease outbreaks.

What are the symptoms of pharyngitis / scarlet fever?

• People with strep throat often have fever and sore throat with swelling of the tonsils.
• Patients with scarlet fever may have all the symptoms associated with a sore throat plus a small, reddish rash.
  • The rash usually appears on the neck, chest, armpits, elbows, groin, and inner thighs.
  • In severe cases of scarlet fever, strawberry tongue, vomiting and fever may also be present.
  • During recovery from scarlet fever, the skin on the fingers and toes may flake off.

When do symptoms start?

Symptoms usually begin 1-3 days after exposure to group A streptococcal bacteria.

How to treat pharyngitis / scarlet fever?

Sore throat and scarlet fever can be treated with antibiotics prescribed by your doctor.

If left untreated or only partially treated (ie not taking all prescribed medications), streptococcal infections can sometimes lead to rheumatic fever or kidney disease.

Should people with pharyngitis be excluded from school or work?

Yes. Untreated people can carry bacteria for several weeks.With adequate treatment, the infectious period is reduced to 48 hours or less.

Persons infected with sore throat may return to school or work 24 hours after starting antibiotic therapy.

How to avoid pharyngitis?

• Avoid close contact with infected people until they have completed at least 2 days of 10 days of antibiotic therapy.
• Do not drink raw (unpasteurized) milk and do not eat foods made from raw milk.
• Exclude people with respiratory or skin problems from handling food.

Where can I get more information?

Contact your doctor or the Southern Nevada Department of Epidemiology at (702) 759-1300.

Streptococcus in children

Streptococci are microorganisms in the form of bacteria in the shape of a ball, united by common properties and existing in the environment around us – on plants, animals, in the earth and in the human body.Many streptococci are completely safe for people and are a natural attribute of the microflora of a completely healthy person. But among the streptococcal family there are some species that cause diseases in children and adults of varying severity.

Streptococcal infection manifests itself completely differently in each child. Moreover, if a baby is a carrier of this infection, then, without getting sick himself and without showing symptoms of the disease, he can infect another person. Children with impaired functioning of the immune system are at risk, when the body is poorly protected and is not able to resist an infection transmitted by airborne droplets.Streptococcus is easily transmitted through damaged skin (cracks, cuts, umbilical wounds in newborns, various injuries), as well as sexually and due to violation of personal hygiene rules.

Located in the nasopharynx cavity, in the respiratory and digestive tracts, in the urinary system, streptococci cause diseases such as scarlet fever, tonsillitis, tonsillitis, pneumonia, bronchitis in children. Getting on the affected skin, streptococcus bacteria can cause erysipelas, streptoderma, and sepsis.An insidious streptococcal infection does not ignore the nervous and autoimmune systems, provoking the development of streptococcal meningitis, rheumatism, osteomyelitis and other life-threatening and health-threatening diseases in children.

Streptococcus species:

• Beta-hemolytic streptococci group A . Most often they are located in the pharynx and cause various diseases in the form of tonsillitis, pharyngitis, meningitis, sepsis, scarlet fever;
• Pneumococcus .It is located in the respiratory tract, causing acute pneumonia, bronchitis, meningitis in children, etc.;
• Group B streptococci . They live in the gastrointestinal tract, and are also often found in pregnant women, and when the child passes through the birth canal of an infected mother, they can cause meningitis and bacteremia in the newborn. In adults, this streptococcus often causes pneumonia;
• Nonhemolytic (greening) streptococci live in the oral cavity and intestines, easily entering the bloodstream and spreading throughout the body.Can provoke the development of caries , sepsis, infective endocarditis.

Diagnostics

The simplest way to identify streptococci is a special bacteriological culture from foci of infection: a smear from the throat, from the skin, sputum from the lungs, etc. The taken biomaterial is tested for antibiotic sensitivity to prescribe an effective treatment. Also, to clarify the diagnosis, the child is tested urine, blood, electrocardiography.Perhaps the appointment of an ultrasound scan of organs presumably infected with streptococcus.

According to the results of the analyzes, the treatment of a young patient, depending on the location of the streptococcal infection, is carried out by appropriate pediatric specialists – an otolaryngologist, a pediatric urologist, a nephrologist , a dermatologist, pulmonolo g, a pediatrician.

Treatment

For the treatment of streptococcal infection, antibiotics, immunostimulating agents, symptomatic therapy are most often used.

Our clinics in St. Petersburg

You can get detailed information and make an appointment by calling
+7 (812) 640-55-25

OGBUZ “Dermatovenerologic dispensary”

Smoking is one of the most pernicious habits.

Despite the fact that doctors have long proven that smoking can lead to serious health problems, the number of smokers is growing every year.

How does nicotine affect the skin? The ingestion of nicotine leads to a narrowing of blood vessels and arterioles, which provide nutrition and respiration of the skin. Spasms caused by periodic vasoconstriction provoke oxygen starvation, poor supply of nutrients to the skin, which impairs the ability to regenerate .And this is very important, since the epidermis is regularly renewed, due to which the healing of wounds and abrasions occurs, and the elasticity and freshness of the skin is also maintained.

As a result of the fact that oxygen, which should enter the blood, is replaced by carbon monoxide and spreads through the circulatory system, the body develops oxygen starvation. The skin and organs do not receive the required amount of oxygen, which worsens their condition and function.

Toxins entering the body turn into free radicals that cause cell mutation and accelerate the aging process .The development of such consequences as the destruction of elastin and collagen, a lack of vitamins A and E occurs over several years of regular cigarette smoking.

As a result, its firmness and elasticity are lost, the skin becomes thinner, noticeable dryness appears, wrinkles are formed. I elasticity and freshness of the skin.

Many have heard the expression “smoker’s face”. What does “smoker’s face” mean:

Uneven skin tone. Smoking leads to impaired blood circulation, as a result – nutrients and oxygen are not supplied, the complexion deteriorates, acquiring a pale yellow tint.

• Yellowness of the skin. Yellow th complexion is caused by the same consequences of smoking as uneven color: vasoconstriction, impaired blood circulation. In addition to the face, nails, teeth, fingernails and fingers turn yellow.

Expression wrinkles. Smokers suffer from the premature appearance of mimic wrinkles around the eyes and nasolabial part of the face. This is due to the fact that when they exhale cigarette smoke, they have to squint and curl their lips.

Sagging skin. Due to the destruction of collagen and elastin during smoking, the skin loses its elasticity and sags, and wrinkles become deeper.

• Blackheads and pimples. The ingestion of substances contained in cigarette smoke on the skin clogs the pores, which contributes to the formation of inflammation and the appearance of blackheads on the face.
• Vascular mesh on the face.The skin of the face, as a result of constant exposure to nicotine, suffers from normal blood circulation, the skin becomes thinner and small vessels become visible, forming a fine mesh on the face.
• Pigmented spots. Smoking exposes your skin to more UV rays, which contributes to the appearance of age spots.
• Bruises under the eyes. A smoker exposes his blood vessels and heart to additional stress, since the vessels are narrowed.This leads to increased pressure and tension of the walls of the vessel, the external manifestation of this is lilac circles under the eyes.
• Dry or oily skin? The smoker has dry skin. Even if the skin was oily before smoking, the constant exposure to smoke and the deposition of harmful components make it very dry.

The effect of smoking on skin tissues is not limited to their premature aging.This bad habit contributes to the development or aggravation of the course of many dermatological diseases.

Poor wound healing. Damage to the dermis, including after trauma or surgery, heals more slowly. The risk of infectious complications, vascular thrombosis, tissue necrosis increases. The reasons for this are associated with a lack of oxygen, slow migration of skin cells to the lesion, and impairment of collagen synthesis. In the area of ​​the wound, the formation of new blood vessels is disrupted.The addiction contributes to the development and long-term course of skin ulcers, for example, with diabetes or varicose veins.

Infectious diseases. The likelihood and severity of the course of staphylococcal and streptococcal infections (erysipelas, streptoderma, pyoderma and others), thrush on the oral mucosa, viral papillomatous infection, including genital warts, increases. In the presence of genital warts, the risk of cancer increases (in men – tumors of the penis, in women – of the cervix and vulva).

Skin cancer. The risk of developing squamous cell skin cancer is doubled. The risk of oral leukoplakia (precancerous condition), tongue and lip cancer also increases. Quitting the bad habit reduces the risk of lip cancer metastasis by 2 times.

Palmar-plantar pustulosis. This is a chronic, difficult to treat dermatosis characterized by redness, rash, and scaling on the soles and palms. Basically, the disease develops in middle-aged women who smoke.The pathogenesis of the disease is explained by the binding of nicotine to acetylcholine receptors in the sweat glands and their ducts, which changes their structure and causes constant inflammation. The manifestations of the disease can also affect the sweat glands located on the face.

• Psoriasis. Psoriasis is more severe in smokers. Nicotine stimulates the formation of inflammatory mediators and the proliferation of keratinocytes.

• Discoid lupus erythematosus. The risk of this disease increases 10 times.Autoimmune activity is increased by stimulating leukocytes. Treatment in this case is less effective.

In addition to the skin of the face, the oral cavity also suffers: candidiasis, cheilitis (inflammation of the lips), angulitis (cracks in the corners of the mouth), inflammation of the gums and tongue are often observed.

Much more dangerous can be the effect of cigarettes and nicotine on the skin with existing diseases, hereditary predisposition to them or other risk factors.

Exposure to high temperatures, carcinogenic substances contained in tobacco smoke and free radicals formed during the breakdown of cigarette components can cause the development of melanoma – a malignant tumor of the skin.This cancer in smokers is 2 times more likely to metastasize to other organs and 2 times more likely to lead to deaths.

In addition to melanoma, smokers are at risk of lip cancer and cancer of the oral mucosa, the risk of getting these diseases among nicotine lovers is 77.5 times higher!

Another specific disease of the smoker is Vincent’s disease, in which the skin of the gums becomes inflamed and begins to die off. And what sensations the patient experiences at the same time and how dangerous it is, everyone can imagine for himself.

Even episodic smoking extremely extreme and total , only completely abandoning 9034 9034 9034 9034 0328 cigarettes hopes and healthy 9032!

Scarlet fever

Scarlet fever is an infectious disease characterized by inflammation of the pharyngeal mucosa, sore throat, fever and a characteristic rash.Caused by a bacterium – group A beta-hemolytic streptococcus.

English synonyms

Scarletfever, Scarlatina.

Symptoms

Symptoms of scarlet fever usually appear 1-4 days after infection. The disease most often begins suddenly and acutely, the following manifestations are observed:

• Fever (increased body temperature). The temperature reaches 39-40 degrees. Often accompanied by nausea, vomiting.
• Enlargement and swelling of the palatine tonsils.
• Sore throat, difficulty swallowing. In this case, there is a pronounced scarlet redness of the throat, swelling of the pharynx, the appearance of small red bumps on the palate. The tongue is unevenly colored red and covered with a white coating (“crimson tongue”).
• Pain in the abdomen, muscles.
• Enlargement of the cervical lymph nodes.
• Malaise, headache, loss of appetite.
• A characteristic rash appears on the first, less often on the second day of the disease.The rash is red, rough, dry patches that look like sandpaper in texture. The rash consists of very small specks. It appears on the upper body, chest, armpits, then spreads throughout the body. There is redness on the face, “burning” cheeks and lips, while the nasolabial triangle remains pale and free from lesions. Most often, lesions in the form of brighter stripes appear in various folds – on the armpits, on the inner surface of the elbows, knees, on the folds of the neck, in the groin folds.The rash is usually not painful, with occasional slight itching.
• Rashes and facial flushing last for about a week. After 4-5 days, the rash begins to gradually disappear, while the skin often exfoliates in layers, especially on the fingers and toes.

Scarlet fever is contagious to others from the first hours of the illness and for 3 weeks after the onset of the first symptoms.

General information about the disease

Scarlet fever is an infectious disease that most often occurs in children and is characterized by inflammation of the pharyngeal mucosa, sore throat, fever and a characteristic rash.

The disease is widespread, especially among children from 5 to 15 years old. It is rare in children under 2 years of age because mothers who are immune to scarlet fever pass it on to their baby. By the age of 10, 80% of children have protective antibodies against streptococcal toxin in their blood. The disease occurs with the same frequency in both sexes.

Scarlet fever can also be observed in adults, although sensitivity to the pathogen decreases significantly with age.Outbreaks of scarlet fever are usually observed in autumn-winter and spring, in children’s groups – schools, kindergartens.

Scarlet fever is caused by beta-hemolytic streptococcus of group A. The causative agent of scarlet fever is stable in the external environment, withstands boiling for 15 minutes, exposure to many disinfectants. Infection most often occurs by airborne droplets (when coughing, sneezing, screaming, talking), less often by household means (through towels, dishes, clothes, furniture, toys, bedding, etc.). The carrier of the causative agent of scarlet fever is only a person.

When bacteria enter the pharynx, they attach to the mucous membrane and begin to produce a toxin (Dick’s toxin, rash toxin) that causes most of the symptoms of scarlet fever, including fever and a characteristic rash. In response to the production of toxin, the human immune system produces anti-toxic antibodies. The action of the toxin causes the expansion of small blood vessels in the tissues of the body, including the vessels of the skin and mucous membranes.In addition, bacteria cause an allergic reaction in the body caused by their waste products.

Without treatment, scarlet fever can lead to the development of various complications associated with the spread of streptococcal infection throughout the body or with impaired functioning of the body’s immune system.

Complications due to the spread of streptococcal infection:

• Otitis media – inflammation of the ear.
• Sinusitis is an inflammation of the paranasal sinuses.
• Pneumonia – pneumonia.
• Meningitis is an inflammation of the lining of the brain and spinal cord.
• Paratonsillar (peri-medial) abscess. This is a large abscess that occurs in the tissues surrounding the tonsils. Surgical opening of the abscess is required.
• Sepsis (blood poisoning) is a life-threatening condition.

Complications caused by impaired functioning of the patient’s immune system. In this case, the antibodies produced by the body to the toxin and other proteins of streptococcus form complexes with them, which are deposited in the tissues of the heart and kidneys, causing inflammation and damaging these organs.In addition, the body’s immune system can mistake its own tissues for foreign ones. This is due to the fact that streptococcus proteins have a similar structure to the body’s own tissues. These “immune” complications occur 2-3 weeks after the transferred and untreated (untreated) streptococcal infection. These complications include:

• Acute rheumatic fever (rheumatism). This is a disease that affects various organs and systems. It is manifested by swelling of the joints and heart damage with the development of defects.
• Acute glomerulonephritis is an acute, usually severe inflammation of the kidneys.

In the absence of complications and the use of antibiotics, the prognosis of the disease is favorable.

Who is at risk?

• Children from 5 to 15 years old.
• Persons who have had contact with a patient with scarlet fever.
• Primary school teachers, kindergarten teachers, health workers, kindergarten students, schoolchildren.

Diagnostics

Scarlet fever is assumed by the characteristic symptoms, the appearance of the oral cavity and the patient’s rashes. To make a diagnosis, laboratory tests are required. It is very important to establish a diagnosis in a timely manner, because the treatment of a particular disease will depend on it.

• Complete blood count. In the general analysis of blood, a significant increase in the level of leukocytes is usually observed.
• Throat swab.This study involves the collection of material from the pharynx, posterior pharyngeal wall, tonsils, followed by placing the samples in a nutrient medium, where bacteria begin to multiply rapidly and become available for visual assessment. The results of the study are available in 5-7 days, which does not allow using this analysis to determine the need for antibiotic prescription.
• Determination of DNA of the causative agent of scarlet fever by polymerase chain reaction (PCR). Currently, there is an express method that helps to confirm the role of group A hemolytic streptococcus in the development of inflammation.For this, the determination of the genetic material of streptococcus by the method of polymerase chain reaction (PCR) is used. The result is ready almost instantly, which allows you to decide whether to prescribe antibiotics.
• Antistreptolysin-O (ASL-O). ASL-O is an antibody produced by the body against streptococcus. They can be found in the blood. An increase in their level in the blood indicates a recent streptococcal infection. Usually, several tests are performed with an interval of 2 weeks, so in a single test there may not be an increase.In sequentially taken analyzes, after a streptococcal infection, an increase in the amount of ASL-O will be noted.

The volume of additional research is determined individually by the attending physician.

Treatment

Treatment of scarlet fever consists of taking antibiotics. The drugs of choice are penicillins. It is extremely important to complete the entire course prescribed by the doctor. Failure to follow the principles of treatment can lead to the development of complications in the child.

A patient, especially with an average and severe course of the disease, usually needs bed rest and an abundant warm drink. Various medicines can be used to relieve fever and sore throat.

A child can attend an educational institution a day after the disappearance of the fever.

Prevention

The following methods will help reduce the risk of developing scarlet fever:

• Teaching the child hygiene rules, in particular washing hands with soap after a walk, before eating.Also, the child should use individual dishes, a towel.
• If there is a patient with scarlet fever, he should be given a separate dish, towel, toys. When communicating with healthy people, friends, classmates, cover your mouth with a handkerchief or use a special mask. A child’s toys and clothing should be thoroughly washed in hot, soapy water.

There is no vaccine for group A beta-hemolytic streptococcus.

Recommended analyzes

Literature

• Dan L.Longo, Dennis L. Kasper, J. Larry Jameson, Anthony S. Fauci, Harrison’s principles of internal medicine (18th ed.). New York: McGraw-Hill Medical Publishing Division, 2011.
• http://emedicine.medscape.com/article/1053253-overview
• http://www.mayoclinic.com/health/scarlet-fever/DS00917
• http://www.merckmanuals.com/professional/infectious_diseases/gram-positive_cocci/streptococcal_and_enterococcal_infections.html

Rash in a child: causes and treatment

Sometimes a rash may appear on the delicate skin of a baby.In this article, you will learn what types of rashes are most common in young children and how to treat them.

It is not possible to 100% rule out a rash in a child, but you can reduce the risk of some types of rash. Read the article and you will find out everything!

What is a rash

A rash is an inflammation or irritation of the skin that causes the skin to redden, become uneven, and may flake off. The rash may be accompanied by itching and sometimes fever.Be aware that a child’s rash can be a sign of an allergic reaction and may require immediate medical attention.

In this article, we will discuss the most common types of rashes in young children. Our list is not exhaustive, and if you have any questions or concerns about your baby’s skin condition, be sure to contact your pediatrician.

Rash in a child: causes

Here are some reasons for a rash in a child:

• Insect bites

• Allergy

• Bacteria

• Fungus

• Viruses

• High temperature

• Humidity41

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  Saliva

Most common rashes in young children

In this section we discuss the most common rashes and skin conditions in newborns and babies.

Diaper rash

Diaper rash, or diaper dermatitis, is a reddish rash in a baby that appears on the baby’s skin under and around the diaper. The structure can be either flat or convex. Able to cause significant discomfort to the baby.

Diaper rash can occur if the baby spends too much time in a wet diaper or if the diaper is too small for him.

If the cause of diaper rash is eliminated, it usually goes away in three to four days.Therefore, try to change your baby’s diaper as often as possible. Clean the area under the diaper with wet wipes or a cloth dampened with water and, if possible, give your baby an air bath. It is also recommended to use an anti-diaper rash cream to create a protective barrier on the skin.

Atopic dermatitis

Atopic dermatitis (or itchy rash), sometimes occurs in babies after the first month of life.

You may notice red cheeks in your baby and red, dry, scaly patches of skin on the elbow or under the knees.In infants, atopic dermatitis is more common on the body than on the face. The rash can be mild, but it can also be accompanied by severe itching and cause great discomfort to the baby.

If you suspect your baby has atopic dermatitis, consult a pediatrician – he will be able to prescribe an ointment or cream for treatment and care.

To get rid of this unpleasant condition or prevent its recurrence, use a mild, odorless soap to care for your baby, choose clothes made from soft fabrics and bathe the baby no more than three times a week.Use unscented detergents to wash baby clothes.

Rash from drooling

Sometimes babies develop a rash on the chin and around the mouth, caused by irritation of the skin with saliva. Profuse salivation can occur during teething.

If your baby is drooling a lot, rubbing his face regularly will help prevent rashes. If your child still has a rash or persists, seek a doctor’s recommendation.

Food Allergy Rash

When introducing complementary foods, try to add one food to your baby’s diet every three to five days to avoid food allergies.If a product causes an allergy in your baby, you may notice red cheeks in your baby and a rash on your baby’s body. Other possible symptoms of food allergies are vomiting and diarrhea.

If you notice any of these symptoms, consult your doctor.

Toxic erythema

This type of rash occurs in newborns in the first days of life. Toxic erythema looks like red spots with yellowish-white blisters. A rash on the child’s body does not require treatment and goes away in about a week.The exact cause of the development of toxic erythema is unknown.

Neonatal acne

Acne, or pimples, can appear on the face of a newborn, usually on the cheeks, nose and forehead. As with acne in adolescents or adults, neonatal acne appears as red or white pimples that can occur between two and four weeks after birth. There is no way to eliminate acne in babies, but over time, the rashes go away without leaving scars. One of the causes of acne is considered to be overly active work of the sebaceous glands on the baby’s skin, caused by the specific action of maternal hormones (androgens).

Milia

Milia in newborns are white pimples that can occur on the cheeks, chin, or tip of the nose. Such rashes appear due to the secretions of the skin glands and usually disappear within the first two to three weeks of the baby’s life.

Prickly heat

Prickly heat is a rash on a child’s body, which occurs as a result of a blockage of the sweat gland ducts and in most cases is associated with overheating of the body. Miliaria in children is a small red rash or small pimples filled with fluid that disappears in a few days.The provoking factor for the appearance of prickly heat can be high humidity and air temperature.

Scabs on the head

Scabs, or seborrheic dermatitis, look like dense scaly growths on a baby’s head. They can also form on the neck, in the armpits, behind the ears, and even in the groin area. At times, you may also notice redness or a rash. Usually, the crusts disappear by themselves in a few months.

If the crusts are only on the head, try gradually brushing them out with a soft brush as you wash your baby’s head.Sometimes you may need a special shampoo that your pediatrician can prescribe.

Scabies

Scabies is a rash caused by microscopic mites that invade the skin and lay eggs. After that, a rash in a child with scabies usually occurs within two to four weeks.

Scabies occurs in both infants and older children, but it manifests itself in different ways. In infants, it looks like pimples filled with fluid, and the rash usually occurs only on the palms and soles of the feet.In older children, you may notice small bumps next to the reddened areas of the skin – the itch passages that the tick makes.

If you suspect your child has scabies, see your doctor. The specialist will be able to do a scraping to rule out or confirm the disease and, if necessary, prescribe treatment. Because scabies is a contagious dermatological condition, your doctor may recommend treatment for the whole family.

Urticaria

Urticaria is a fairly extensive rash on the body of a child, accompanied by itching and the appearance of blisters that have a deep pink color.The rash owes its name to its resemblance to nettle burns. Hives can appear both in one area and throughout the baby’s body and even move from one area to another for several hours.

Causes of urticaria:

• Infection (viral, bacterial, parasitic)

• Food allergies such as peanuts, nuts, eggs, dairy products and seafood

• Allergic reaction to contact with something, such as an animal or plant

• Insect bite, including bees

• Reaction to medication (eg antibiotics)

It is generally recommended to take antihistamines for urticaria to help relieve itching.A cold compress applied to the area of ​​the skin affected by the hives can also provide relief.

If the child has difficulty swallowing or wheezes, call an ambulance immediately, as these may be symptoms of anaphylactic shock.

Impetigo

Impetigo is a contagious skin disease that usually affects the nose, mouth and ears. The infection is caused by staphylococcal or streptococcal bacteria, and a baby who has impetigo will need antibiotics. The doctor will order an analysis to find out which bacteria caused the infection and then determine the course of treatment.Impetigo is contagious as long as the child has a rash that sometimes blisters and eventually crust over. At this stage, contact between the baby and other children should be avoided. Avoid touching the rash to prevent the spread of the infection.

Ringworm

Ringworm is a skin disease caused by a fungus and manifests itself in lesions of various sizes: oval, rounded or well-defined. Such lesions can appear on the scalp and on the baby’s body.With shingles, hair breakage and loss are observed if they are in the area of ​​infection.

The infection spreads from person to person and even from animals to people. If a child has ringworm, no one in the family should use their comb, hair accessories, or headgear.

Ringworm can sometimes be confused with dandruff or scabs on the scalp. If your baby is over a year old and has a scaly rash on the scalp, it is most likely ringworm, not crusts.An accurate diagnosis can be made by a doctor.

If you suspect your child has ringworm, see a specialist. By following your doctor’s instructions, you are likely to say goodbye to shingles in about a week. As a rule, external agents are prescribed for treatment.

Roseola

Roseola is a contagious viral infection. Symptoms include a pink rash on the baby’s body, including the arms and neck. A child’s body rash occurs after the child has a fever and symptoms that resemble a cold or flu.Roseola is most common in children under two years of age. The first signs of roseola appear ten days after infection.

If a child has a temperature of 39 degrees or more during the day, contact a doctor as soon as possible for advice on how to bring down the fever.

The doctor may also order a blood or urine test to clarify the diagnosis.

While the baby has a fever, it is recommended to isolate him from other children to avoid spreading the infection.Once the rash disappears, the baby is no longer contagious.

Frequently asked questions

• What does prickly heat look like?

  Prickly heat is manifested by red small rashes, sometimes in the form of bubbles. The characteristic lesions are skin folds.

• What is a viral rash in a child?

  Viral rash is a rash that is a symptom of a viral infection. Such is, for example, a rash with roseola.

• How is rash treated in young children?

  Treatment of the rash depends on the cause of the rash.It is recommended that you consult with your doctor to determine the cause of the rash and receive directions for treatment. Prescription or over-the-counter creams or ointments may be needed to treat the rash.

• How do you know if a child’s rash is dangerous?

  It is recommended to take the child to a doctor in order to establish the cause of the rash and, if necessary, receive recommendations for treatment.

A rash in a child, especially when combined with other symptoms, can be very distressing for parents.It would be best to seek the advice of a doctor in order to establish the exact cause of the rash and receive recommendations for treatment.

You will not have time to notice how the baby will recover. His skin will be healthy and smooth again, and you will shower him with kisses.

_{How this article was written
The information in this article is based on expert advice from trusted medical and government sources such as the American Pediatric Association and the American College of Obstetricians and Gynecologists.}