The rash tends to be most prominent on the neck and in the major skin folds.
A distinctive feature is circumoral pallor as a result of the rash sparing the area around the mouth.
As with measles, desquamation is seen but the hands and feet are involved.
True scarlet fever is associated with inflammation of the tongue (white and red strawberry tongue).
Scarlatina refers to the rash which may occur alone in milder streptococcal infection, and is often short lived.
Erythema infectiosum or fifth disease
Infection caused by parvovirus B19
is associated with a rash which develops in two stages.
The cheeks appear red and flushed, giving rise to a ‘slapped cheek’ appearance. A maculopapular rash develops
1–2 weeks later, predominantly over the arms and legs which, as it fades, appears lace-like.
Causes non immunehydrops is caused by parvo virus.
The main cause is human herpesvirus 6 (HHV-6).
Roseola infantum is characterized by a widespread morbilliform (measles-like) rash, seen in its most florid form on the trunk.
The lesions tend to be discrete.
As the rash appears the fever, which is normally present over the previous 4 days, resolves and the child looks well (in contrast to measles, in which the child is febrile and unwell when the rash appears).
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