Scarlet fever consists in a diffuse exanthem associated with mucous changes. 
Classical scarlet fever is rare now, but other severe streptococcal infections 
have become more frequent, such as streptococcal toxic shock syndrome. The 
scarlatiniform exanthem and the shock observed in this disease are due to a 
streptococcal pyrogenic exotoxin. Exfoliative toxins secreted by Staphylococcus 
aureus are responsible for the tender erythema and cutaneous scaling 
characteristic of staphylococcal scalded skin syndrome of infancy. The so-called 
staphylococcal scarlet fever is probably an attenuated variant of this disease. 
Toxic shock syndrome toxin 1 (TSST1) is another staphylococcal toxin implied in 
the staphylococcal toxic shock syndrome. This disease is characterized by 
general symptoms and a scarlatiniform exanthem which are due to the effects of 
TSST1, acting as a superantigen.