SDN Members don't see this ad. (About Ads) so we all know this 'sandpaper' rash is notriously linked to strep, or more specifically, scarlet fever. but what if you have the classic sandpaper rash and fever but no evidence of pharyngitis? i remember as an intern one of the nurse practioners treated the same case with pcn (e.g., no sorethroat, no neck tenderness, normal pharynx). after some authoritative googling, it appears viral processes can cause a similar rash. would you tx, maybe cx or just have them f/u with pmd?