Covid19 Symptom: Rashes on Toes

Covid19 Symptom: Rashes on Toes

Everybody is perfectly aware at this point of the most common symptoms of the COVID-19 infection: cough, fever, shortness of breath, sore throat, muscle aches, fatigue, loss of smell and taste. Digestive problems as diarrhea have been reported as well; however, another clinical sign has been reported recently on certain COVID-19 cases that has brought the attention of experts, which is the presence of skin lesions on the toes.

This condition, initially called “COVID toes,” frequently starts as small red or purple superficial lesions on the toes, similar to a typical rash; however, these small lesions might evolve into blisters, bumps, and even ulcerations. It is not completely clear yet when these skin lesions are more likely to start; however, it has been reported during weeks after the infection has been resolved. People affected by COVID toes describe an initial sensation of itchiness and burning, but it might turn into painful lesions. Clinically it might present similar signs and symptoms as Raynaud’s syndrome.

The cases reported and studied so far suggest that the COVID toe usually presents as either the first symptom of several to manifest or even the only sign of the COVID-19 infection. Initial reports from China suggested a very low incidence of COVID toes. (around 0.2% of confirmed positive cases) A small study carried out in Italy concluded that this affection was present in approximately 20% of their cases. Finally, more recent reports from Spain and the USA suggested that COVID toes are prevalent enough to systematically start collecting data to further study this condition.

Some experts who have already started studying this new clinical presentation believe that these toe skin lesions are directly triggered by the well-known inflammatory response that follows COVID-19. This is especially remarkable if we consider that has been reported more incidence of COVID toes among adolescents and kids, which under normal conditions are included among the population with the more robust immune system (Stronger immune system usually means more amplified inflammatory response). In addition to that, it is well-known that the Coronavirus itself may cause clotting in small blood vessels (cases of DVT (Deep Venous Thrombosis) have been widely reported, even weeks after overcoming the infection) that might ultimately affect the normal blood circulation on toes. In short, inflammatory response and small-blood vessel clotting appear to be responsible for COVID toes.

It is worth mentioning that a specific group of patients who displayed very similar signs and symptoms as COVID toes tested negative for Coronavirus or did not have antibodies for COVID-19. A strong theory to explain it is that people became remarkably less active during the world-wide lockdowns, spending long periods in sedentary positions, promoting blood-vessels clotting.

Treatment for COVID toes

In most cases, it should be a purely symptomatic treatment, applying corticoid creams to alleviate itchiness or antiseptic agents on blisters or superficial ulcerations to avoid infection or other complications. Other than that, the condition requires time to resolve. In case of doubt or complications, a visit to a podiatrist is indicated.

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