The most important feature of scarlet fever is the rash, which usually begins the day after the onset of fever. The rash begins behind the ears, neck and chest and spreads to the whole body within 24 hours.
The typical rash is an evenly distributed, pinpoint rash that discolours on pressure and is accompanied by an itchy sensation. Most of the rash peaks within 48 hours and then gradually fades in the order in which it appears, within 2-3 days, or up to 1 week in severe cases. The rash begins to moult a week after it subsides, in the same order as the rash.