Rocky Mountain spotted fever usually starts out as a small pink, flat, non-itchy spot on the wrists, forearms, and ankles. The spots eventually become raised on the skin. They turn pale when pressure is applied. The red and spotted rash that is characterised of Rocky Mountain spotted fever does not show up typically until the 6th day or later. This type of rash occurs in about 35% to 60% of patients with Rocky Mountain spotted fever. Some people (about 10-15%) will never develop the rash.
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