What does the "sandpaper" rash of Scarlet Fever actually feel and look like?

drjoseph

Everyone calls it a sandpaper rash, but can someone describe it in more detail? Does it itch? On which parts of the body does it usually start, and where does it spread? Are there any pictures that accurately show it?

dranil

The “sandpaper rash” of scarlet fever is red, rough, and feels like tiny raised bumps, often starting on the neck, chest, and abdomen before spreading to the back, arms, and legs, usually sparing the palms and soles. It may be mildly itchy and is often accompanied by a flushed face with a pale area around the mouth. The rash can appear more intense in skin folds (Pastia’s lines) and peels on fingertips, toes, and groin as it fades over the following weeks.

drjohn

The scarlet fever rash usually appears 12 to 48 hours after the first symptoms like fever and sore throat. It often starts on the neck, chest, or underarms and then spreads to the rest of the body, including the arms and legs. The rash consists of tiny red bumps that give the skin a rough, sandpaper-like texture. It is generally not very itchy, though some people may notice mild itching. The face can appear flushed, but the area around the mouth usually stays pale, a feature called circumoral pallor. In the folds of the skin, like the elbows and armpits, the rash may form darker lines called Pastia’s lines. As it fades, peeling of the skin, especially on the fingers and toes, is common.