From the Guidelines
Scarlet fever is not directly associated with causing palmar skin to slough off, however, a similar condition, Kawasaki disease, can cause desquamation of the fingers and toes that may extend to involve the palms and soles. The evidence from the American Heart Association 1 suggests that desquamation in Kawasaki disease usually begins in the periungual region within 2 to 3 weeks after the onset of fever. Key characteristics of this condition include:
- Erythema of the palms and soles
- Firm and sometimes painful induration of the hands or feet
- Desquamation of the fingers and toes that may extend to the palms and soles
- Deep transverse grooves across the nails (Beau’s lines) at 1 to 2 months after fever onset. It's essential to note that scarlet fever, caused by group A Streptococcus bacteria, has distinct clinical features, including a rash and fever, but the provided evidence does not directly link it to palmar skin sloughing off. If skin peeling on the palms is observed, especially following a fever and rash, it's crucial to seek medical attention for proper diagnosis and treatment, as various conditions could be responsible for this symptom.
From the Research
Scarlet Fever Symptoms
- The studies 2, 3, 4, 5, 6 describe the typical symptoms of scarlet fever, including a distinctive rash, sore throat, and flushed cheeks.
- The rash is a key diagnostic feature, reported in 89% of cases in one study 5.
- Other symptoms, such as fever, enlarged lymph nodes, and tonsillar exudate, are also common 6.
Skin Sloughing
- None of the studies 2, 3, 4, 5, 6 specifically mention palmar skin sloughing as a symptom of scarlet fever.
- The studies focus on the typical symptoms of scarlet fever, such as rash, sore throat, and fever, but do not discuss skin sloughing in detail.
Complications
- One study 2 mentions that untreated scarlet fever can lead to complications, but does not specify what these complications are.
- Another study 4 recommends treating scarlet fever with antibiotics to reduce the risk of complications, but does not provide further information on what these complications might be.
- There is no direct evidence in the studies to suggest that scarlet fever can cause palmar skin to slough off.