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AKT6-113

Sarah is a 8 year old girl who attends with her mother due to a 2 day history of a bad sore throat and fever, followed by a rash on her trunk this morning. On examination, observations are stable except for a temperature of 38 °C and you note her tongue looks raw with prominent papillae, inflamed tonsils, and cervical lymphadenopathy. There is a rough diffuse erythematous rash on her neck and chest.

Based on the likely diagnosis, which of the below features is least in-keeping with the associated rash?

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