MRCP UK EXAMINATIONS

A 7-year-old boy presented to the hospital with an acute catarrh in pharynx and tonsils which had extended on a mouth mucosa, tongue and fauces. A tongue was fiery red (crimson red) with prominent papillae (’raspberry’ or ‘strawberry’ tongue). A gross investigation of tonsils showed superficial necroses. A casting-off necrotic tissue resulted in ulcers formation. Cervical lymphatic nodules were enlarged. A punctuate erythematous rash was determined over the trunk, arms and legs. Face was also involved but a small area about the mouth remained unaffected to produce circumoral pallor. What is the most likely diagnosis?