DEAR DR. DONOHUE: My 4-year-old daughter turned red overnight. She had seemed fine that day, but when she woke up the next morning, she was red and couldn’t swallow. We rushed her to an emergency room, and the doctor said she had scarlet fever. He gave her a shot of penicillin and assured us everything would turn out well. It has, but isn’t scarlet fever a dangerous condition? – K.S.

The strep germ, the same germ that causes strep throat, is the scoundrel responsible for scarlet fever. It’s a special strep, one that makes a substance that turns skin red. A strep infection with a strep germ that makes the skin-reddening substance is the cause of scarlet fever. The infection does not have to be a throat infection. It can be an infection elsewhere, but the germ must always be this special strep germ.

The scarlet fever rash begins as a red blush on the upper chest and then spreads to the rest of the trunk, the neck, the arms and the legs. The skin feels like sandpaper.

One distinctive feature of scarlet fever is its strawberry tongue. Early in the infection, the tongue has a white coat, and bright-red taste buds project from its surface. This is the white strawberry tongue. Shortly the white coat disappears and the tongue becomes beefy red – the red strawberry tongue.

Scarlet fever is treated exactly as strep throat is – with penicillin. Treatment shortens the illness somewhat, but more importantly, it prevents heart valve damage that can occur after this sort of strep infection.

In a week or so, the skin peels as sunburned skin would.

When my brother had scarlet fever as a child, our house was quarantined. I was sure this was the first step to imprisonment for our family.

DEAR DR. DONOHUE: I have had rheumatoid arthritis for five years. My eyes started to bother me, and on my last doctor visit I asked her what was wrong with my eyes. They felt gritty. She checked my eyes and said that my arthritis had affected them. Please explain how arthritis affects the eyes. I find it hard to believe. – P.H.

Rheumatoid arthritis, unlike the more common osteoarthritis, is a systemic disease. A systemic disease is one that attacks many body organs. With rheumatoid arthritis, the eye happens to be one of those organs.

Patients with eye involvement commonly complain of gritty eyes. Tear production has been disrupted. Artificial tears or eye ointments keep the eyes moist. It’s not just a matter of getting rid of the gritty sensation – it is necessary to preserve eye health.

Another potential eye problem stemming from rheumatoid arthritis is inflammation of the whites of the eye – scleritis. When this happens, it is best to have an eye doctor involved as a member of the treatment team.

DEAR DR. DONOHUE: You won’t believe what happened to me. I applied for a job that required a urine test for drugs. My urine tested positive. I don’t smoke, drink or take any medicines. I have never used an illegal drug. I protested the results because I knew something must have gotten screwed up. My prospective employer has been nice enough to schedule another test for me. What do you think went wrong? – G.R.

Did you eat anything that had poppy seeds before taking that urine test? Poppy seeds can make urine test positive for some drugs.

Before your next test, avoid anything that might have poppy seeds.

Lest readers wonder if they are going to become addicted to poppy seeds, let me assure them they are not. The amount of drug from poppy seeds is so minute that it has no effect on the body.

DEAR DR. DONOHUE: My husband heard that you can give yourself a test to detect a bad thyroid gland. Before going to bed, you put iodine on your stomach in a circle the size of a half dollar. If the circle is gone in the morning, your thyroid is not working. Is this true? – S.W.

If it is true, it’s news to me.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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