Coronavirus: “Covid toe” and other rashes baffle doctors

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COVID-piel study


Legend

“Covid toe” is a rash that may look like frostbite


A small study by Spanish doctors found that five rashes, including Covid’s toe, affect some inpatients diagnosed with Covid-19.

The rashes tended to appear in young people and lasted for several days.

It is not uncommon for a rash to be a symptom of a virus, such as spots that indicate chickenpox.

But the researchers said they were surprised to see so many varieties of rashes with Covid-19.

Skin rashes are not currently included in the
list of symptoms of the disease.

There have been numerous reports of “Covid’s toe” – a rash appearing on the feet of Covid patients even in the absence of other symptoms – but the lead researcher, Dr. Ignacio Garcia-Doval, has stated that the most common form of rash in the study was maculopapules – small, flat, raised red bumps that tend to appear on the torso.

“It is strange to see several different rashes – and some of them are quite specific,” said Dr Garcia-Doval to the BBC.

“It usually appears later, after the respiratory manifestation of the disease – so it is not good for diagnosing patients,” he added.


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COVID-piel study


Legend

The most common rash seen in the study affected almost half of the patients


All of the patients in the study were already in the hospital with respiratory symptoms.

The peer-reviewed document was
published this week in the British Journal of Dermatology
.

All Spanish dermatologists were invited to share details of the Covid patients they had seen who had developed rashes in the past two weeks. There were 375 in total.

The five rashes were:

  • Asymmetric frostbite lesions around the hands and feet that can cause itching or pain. Generally seen in younger patients, it lasted an average of 12 days, appeared later in the course of the disease, and was associated with mild infections. Represented 19% of cases.
  • Hatching of small blisters, often itching, found on the trunk and limbs. These were found in middle-aged patients, lasted for about 10 days, and appeared before other symptoms. (9%)
  • Raised areas of pink or white skin that looked like a nettle rash and often itchy Mostly on the body but sometimes on the palms of the hands. (19%)
  • Maculopapules – small, flat, raised red bumps. These represented 47% of the cases. They lasted for about seven days and appeared with other symptoms, but tended to be seen in patients with more serious infections.
  • Livedo (also known as necrosis) was present in 6% of the cases. The skin was speckled with red or blue, with a net-like pattern. It’s a sign of poor blood circulation. This has appeared in older patients with severe illness.

However, the researchers pointed out that rashes can have many causes and that it can be difficult to differentiate them without medical expertise.

“The relevance of this study is not so much to help people self-diagnose, but rather to help build our broader understanding of how the infection can affect people,” said the Dr. Ruth Murphy, President of the British Association of Dermatologists.

Dr. Michael Head of the University of Southampton said rashes were a well known side effect of many viral infections, including pneumonia.

“With Covid-19, rashes and skin ulcers have been noted in a few percent of hospitalized patients. We do not yet know the extent of these links, or precisely why this inflammation occurs in some patients but not in others. “

The American Academy of Determatology is also
establish a register of skin symptoms
seen by its members.


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