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( Impetigo (pyoderma), Scarlet Fever, Rhuematic Fever, Acute Post-strep Glomerulonephritis, Strep Toxic Shock ) begins with an outbreak of vesicular lesions on arms and legs, nose, mouth, throat, scalp. Lesions soon become pustular and in time are covered by a thick crust of a dark yellowish color. Patient may complain of itching.