Usually within 2 days of the fever
from a strep infection a red sandpaper like rash
develops on the neck then trunk and extremities.
There can be superficial sloughing of skin, even on the palms. The tongue develops a whitish 'coating' and the classic 'strawberry tongue' look. The rash resolves in 4-7 days and more sloughing (desquamation) occurs, especially on the hands for up to 4 weeks.