>Does anyone really believe in 'Scarlatina'? If so, how do you diagnose it?
>Paul Caldwell
My understanding of scarletina is this.
Several types of group A beta haemolytic strep produce an
"erythrogenic" toxin that is responsible for the unusually
red/pink hue of this rash that looks physically little more
than staining but can eventually desquamate, the latter most frequently
seen on the palms. It goes along with the strawberry tongue
(thank you Hakim) and spares the skin round the lips
(circum-oral pallor). Antibodies are rapidly formed against this
toxin which are long lasting, so it is usually a once only
infection. That is why it can be described with the other
childhood exanthemata like measles, rubella, rubeola etc.
In the bad old days, either because of poor general health,
lack of antibiotics or more virulent bugs, the effects were more
obvious and frequent and the disease left a trail of myocarditis,
rheumatic carditis, glomerulonephritis and arthritis behind it.
Then it was called "scarlet fever". "Scarletina" is the same disease
but the term is used generally to reflect the less virulent
nature of the modern version, namely, streptococcal tonsillitis
with a scarletiniform rash and no complications.
HOWEVER. There are some signs that the tide may have turned.
Doug Jenkinson
Keyworth Health Centre, Bunny Lane, Keyworth, Nottingham NG12 5JU.
[log in to unmask] V. 0115 937 3527 F. 0115 937 6781
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