Differential Diagnosis for Sandpaper-like Rash

The differential diagnosis for a sandpaper-like rash can be organized into the following categories:

• Single Most Likely Diagnosis

  • Scarlet Fever: This is the most likely diagnosis, as the rash is a classic symptom of scarlet fever, caused by Group A beta-hemolytic streptococcal infection. The rash is typically described as feeling like sandpaper and is accompanied by other symptoms such as fever, sore throat, and strawberry tongue.

• Other Likely Diagnoses

  • Kawasaki Disease: This condition is an acute febrile illness that can cause a rash, fever, and other symptoms. While the rash is not always sandpaper-like, it can be a consideration in the differential diagnosis.
  • Toxic Shock Syndrome: This is a severe condition caused by bacterial toxins, which can cause a rash, fever, and other symptoms. The rash can be sandpaper-like in texture.
  • Allergic Reactions: Certain allergic reactions, such as those caused by medications or infections, can cause a sandpaper-like rash.

• Do Not Miss Diagnoses

  • Staphylococcal Scalded Skin Syndrome (SSSS): This is a serious condition caused by staphylococcal toxins, which can cause a rash, fever, and other symptoms. The rash can be sandpaper-like in texture, and SSSS can be life-threatening if not treated promptly.
  • Toxic Epidermal Necrolysis (TEN): This is a severe skin condition caused by medications or infections, which can cause a rash, fever, and other symptoms. The rash can be sandpaper-like in texture, and TEN can be life-threatening if not treated promptly.

• Rare Diagnoses

  • Erythema Infectiosum: This is a viral infection that can cause a rash, fever, and other symptoms. The rash can be sandpaper-like in texture, but it is a less common condition.
  • Pityriasis Rubra Pilaris: This is a rare skin condition that can cause a sandpaper-like rash, but it is often accompanied by other symptoms such as palmoplantar keratoderma and follicular hyperkeratosis.