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CTCL

Cutaneous T-cell lymphoma (Sézary syndrome) can cause erythroderma, but it is a chronic condition with intense, intractable pruritus, not an acute febrile illness.

DRESS

A severe drug reaction characterized by a morbilliform eruption, fever, eosinophilia, and systemic involvement (e.g., hepatitis, nephritis), with onset 2-8 weeks after starting a drug.

Drug reaction

A common morbilliform eruption that typically lacks the 'strawberry tongue,' palatal petechiae, and Pastia's lines seen in scarlet fever.

Kawasaki disease

Also has fever and a 'strawberry tongue,' but is distinguished by conjunctivitis, cervical lymphadenopathy, and changes in the extremities (erythema, edema).

Pustular psoriasis

Presents with widespread erythema studded with sterile pustules, often in a patient with a history of psoriasis, and lacks the pharyngitis of scarlet fever.

Staphylococcal scalded skin syndrome

Caused by a staphylococcal toxin, it features widespread, tender erythema followed by superficial blistering and peeling, with a positive Nikolsky sign.

Toxic epidermal necrolysis

A severe, life-threatening drug reaction causing full-thickness epidermal necrosis and extensive sloughing, far more severe than the desquamation of scarlet fever.

Toxic shock syndrome

Presents with high fever, hypotension, and multi-organ failure, with a diffuse erythematous rash that desquamates, but is caused by a staphylococcal or streptococcal toxin without preceding pharyngitis.

Viral exanthem

Usually a milder illness with a less striking rash and lacks the characteristic sandpaper texture, strawberry tongue, and Pastia's lines of scarlet fever.

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