Oral manifestation of scarlet fever:

The chief oral manifestations of scarlet fever have been referred to as stomatitis scarlatina.  Small punctate red macules may appear on the hard and soft palate and uvula. These are called Forchheimer spots; however, these are not diagnostic since they may be present in other infectious conditions like rubella, roseola, infectious mononucleosis, and septicemia. The palate and the throat are often fiery red. The tonsils and faucial pillars are usually swollen and sometimes covered with a grayish exudate. More important are the changes occurring in the tongue. Early in the course of the disease, the tongue exhibits a white coating and the fungiform papillae are edematous and hyperemic, projecting above the surface as small red knobs. This phenomenon has been described clinically as ‘strawberry tongue’.  The coating of the tongue is soon lost; beginning at the tip and lateral margins, and this organ becomes deep red, glistening and smooth except for the swollen, hyperemic papillae. The tongue in this phase has been termed as the ‘raspberry tongue’.