Scarlet fever is best described by which clinical feature?

• A. Sandpaper-like skin rash and fever
• B. Weight loss and night sweats
• C. Chronic cough with sputum
• D. Painless mouth ulcers

Answer: (A)

Scarlet fever is defined by a toxin-mediated eruption that accompanies a streptococcal throat infection. The hallmark feature is a sandpaper-like rash that feels rough to the touch and is usually accompanied by fever. This rash typically begins on the trunk and neck and spreads to the rest of the body, often with accentuation in skin folds, and is commonly paired with a strawberry tongue and circumoral pallor. The other descriptions correspond to different conditions (weight loss and night sweats with TB; chronic cough with sputum for respiratory infections; painless mouth ulcers for aphthous ulcers or other mucosal problems), so they don’t fit scarlet fever.