COVID Toes: New, Mysterious Skin Condition Linked to Coronavirus

© REUTERS / P. RavikumarA doctor in a protective chamber takes a swab from a man to test for coronavirus disease (COVID-19) in India
A doctor in a protective chamber takes a swab from a man to test for coronavirus disease (COVID-19) in India - Sputnik International
US doctors are wondering if a new condition that causes purple, blue or red discoloration in toes and occasionally fingers and which has been exhibited in an increasing number of patients around the country may be connected to COVID 19.

Dr. Amy Paller, a dermatologist for Northwestern Medicine, told NBC Chicago she has seen around 30 cases of the condition that is being referred to by doctors as “COVID toes.” Paller stressed that additional testing is needed to be conducted to determine whether the skin condition is related to COVID-19. However, the timing is curious.

​“We don’t know for sure if it’s related to COVID-19, but when it’s so common right now during a pandemic and is occurring in otherwise asymptomatic or mildly affected patients, it seems too much of a coincidence not to be a manifestation of the virus for patients in their teens and 20s,” Paller said in a statement to the outlet. “I think it’s much more rampant than we even realize." 

However, she also noted that a small number of patients with the skin condition have tested negative for the novel coronavirus, although doctors “still suspect a relationship.”

“Many have had some mild viral symptoms in the week before, and it might be a sign during the 'convalescent' healing period when [the virus is] no longer contagious. We won't understand the association until we can test this more broadly,” she added.

Paller also explained that “COVID toes” seems similar to an inflammatory skin condition called pernio, in which an individual’s skin develops sores or bumps after exposure to cold weather.

"We think something like this may be happening in response to the inflammation, perhaps caused as part of the response to the COVID-19 virus," she noted.

Dr. Esther Freeman, a dermatologist at Massachusetts General Hospital in Boston, also told Today that she has seen cases of “COVID toes.” 

"I wouldn't take purple toes as meaning, 'I'm definitely going to get sick' or 'I'm not going to get sick,'" she said.

Paller and Freeman also noted that the dermatological condition healed “spontaneously” for most people.

The list of coronavirus symptoms continues to lengthen as more knowledge regarding the disease is identified. Initially, markers of the virus included fever, fatigue, coughing or difficulty breathing. However, loss of smell or taste and diarrhea have also been noted as possible symptoms of infection by the US Centers for Disease Control and Prevention and the World Health Organization.

The American Academy of Dermatology has asked health care professionals to fill out surveys to help it understand “dermatologic manifestations of the COVID-19 virus. This survey is for all health care professionals taking care of (a) COVID-19 patients who develop dermatologic manifestations, or (b) dermatology patients with an existing condition who then develop COVID-19,” according to the organization’s website.

During a coronavirus news briefing on Monday, Illinois Department of Public Health Director Ngozi Ezike revealed that skin rashes could be a new coronavirus symptom.

"The beginning of this we were saying it was cough, fever, shortness of breath, we're now seeing a lot of difficulty smelling, loss of smell, we've had some redness of the eyes so there are a lot of different presentations of this virus. The longer we know the virus, the more we see of it - again remembering that we've only known this virus really for the last four months - and so as we get more data, as we see more people who come positive, as we see their symptom of etiology, we develop new symptoms that we see have become more prevalent. We're continuing to amass that data and so I'm not surprised if new symptoms come along that will be shown to be part of the virus,” she noted.

However, while the rashes may become a symptom, they’re unlikely to become a prominent indicator of the virus.

“Again these viruses can show themselves different in different people just like influenza can cause diarrhea in someone and cough in another. So yes, I wouldn't be surprised if rash could be something that could be seen in people, but maybe it's not the majority of people and maybe it's a much smaller minority,” Ezike added.

Currently, more than 2.6 million cases of the coronavirus have been confirmed worldwide, and more than 181,000 people have died as a result. However, increasing evidence regarding the number of asymptomatic infections has generated hope that the virus may not be as lethal as previously thought, though such silent infections could make the spread of the disease harder to contain.

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