Scarlet fever or hand, foot and mouth disease?

Scarlet fever is linked with group A streptococcal throat infection. It commonly presents with fever, sore throat, tender neck glands, and a fine rough rash that may begin on the chest or neck before spreading. Hand, foot and mouth disease is usually recognised by mouth ulcers and spots or blisters on the hands and feet; a rash can also occur elsewhere. The two patterns can overlap, especially early in an illness.

A rash does not identify the infection on its own. Note where it started, whether the mouth is painful, whether there are blisters, and whether swallowing is difficult. Those details help during a [Child Health Consultation](/treatments/consultations-and-assessment/child-health-consultation/).

Offer frequent drinks and soft, cool foods if mouth sores make eating uncomfortable. Keep the child home from close-contact activities while they are unwell and follow local school or nursery advice. Wash hands after nappy changes and before meals; do not share cups, towels, or utensils. Avoid popping blisters. Record the temperature and watch whether the child is passing urine normally. Read more about [Fever](/symptoms/fever/) if temperature is a concern.

Seek urgent help if the child has breathing difficulty, cannot swallow saliva, is difficult to wake, shows dehydration, or develops a rapidly spreading or purple-looking rash. Arrange prompt assessment for severe throat pain, ongoing fever, worsening mouth pain, or a child who is drinking very little. A clinician can decide whether the illness needs testing or treatment.

Ask which rash features support each diagnosis, how to relieve mouth pain, when the child can return to nursery or school, and what hydration signs to check at home.