Prevention
One method is long-term use of antibiotics to prevent future group A streptococcal infections. This method is only indicated for people who have had complications like recurrent attacks of acute rheumatic fever or rheumatic heart disease. Antibiotics are limited in their ability to prevent these infections since there are a variety of subtypes of group A streptococci that can cause the infection.The vaccine approach has a greater likelihood of effectively preventing group A streptococcal infections because vaccine formulations can target multiple subtypes of the bacteria. A vaccine developed by George and Gladys Dick in 1924 was discontinued due to poor efficacy and the introduction of antibiotics. Difficulties in vaccine development include the considerable strain variety of group A streptococci present in the environment and the amount of time and number of people needed for appropriate trials for safety and efficacy of any potential vaccine. There have been several attempts to create a vaccine in the past few decades. These vaccines, which are still in the development phase, expose the person to proteins present on the surface of the group A streptococci to activate an immune response that will prepare the person to fight and prevent future infections.There used to be a diphtheria scarlet fever vaccine. It was, however, found not to be effective. This product was discontinued by the end of World War II. Treatment
Antibiotics to combat the streptococcal infection are the mainstay of treatment for scarlet fever. Prompt administration of appropriate antibiotics decreases the length of illness.
Reactive perforating collagenosis is a rare, familial, nonpuritic skin disorder characterized by papules that grow in a diameter of 4 to 6mm and develop a central area of umbilication to which keratinous material is lodged. The cause of reactive perforating collagenosis is unknown. Clinical Features
Inherited form
Keratotic papules measuring 1 to 6 mm develop on the extensor surface of the hands, the elbows, and the knees following superficial trauma. These lesions are painless. They appear as pin-sized lesions that grow to a papule of about 6mm in the following 3–5 weeks. They undergo spontaneous resolution in about 6–8 weeks leaving residual scarring. Lesions may recur throughout life. Cold weather is one of the factors known to trigger recurrences. Acquired form
In this form, keratotic papules develop on the trunk and extremities. These are commonly associated with pruritus. Lesions may or may not be related to superficial trauma. See also
Elastosis perforans serpiginosa
List of cutaneous conditions

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