Do we have a medical mystery on our toes? What is COVID Toes?

BY JONELL PANTLITZ

From the loss of smell to blood clots, now maybe, COVID toes or COVID hands? Do we have a medical mystery on our hands? Recent discoveries have identified what seems to be a new symptom of our worst enemy COVID-19.

There have been numerous cases of skin rashes in patients with COVID-19 popping up all over the world, and according to anecdotal evidence from dermatologists around the world, they have made links to the virus, and believe this being a new COVID-19 symptom.

According to Dr Kerri Purdy (President of the Canadian Dermatology Association) “They are these painful red and purple bumps that tend to occur at the tips of the toes, on the tops of the feet, on the tops of the fingers, or tips of the fingers.” But these rashes can take many forms and some appear as tiny red spots, while others appear as larger flat or raised lesions. Some have a hive-like appearance, while others look like frostbitten toes.

In an interview with Global News Dr Kerri Purdy mentioned, “Canadian doctors are accustomed to seeing similar lesions, like chilblains associated with cold weather,” she continued, “But it’s more unusual to see them in warm weather.”

“It may be tiny blockages of the small vessels because we think COVID makes people have an increased tendency to blood clots,” said Dr Kerri Purdy.

Initial documentation of skin problems associated with COVID-19 came in late March by a doctor in Italy who established that 18 of the 88 patients studied (20%) had some kind of skin issue.

In response, the American Academy of Dermatology has asked its members and other physicians around the world to report any dermatological symptoms associated with COVID-19 to a registry so doctors can better understand how COVID-19 affects the skin.

A podiatrists’ association in Spain has also opened a registry to track skin conditions that may be related to the virus. France’s National Union of Dermatologists also issued a notice to its members that the lesions can be a possible sign of infection.

The World Health Organization does not list skin problems as known symptoms of COVID-19, but has been watching closely as experts in several countries continue to study the issue. In an interview with Dr Kanade Shinkai, a professor of dermatology at the University of California,” Research is needed to comprehensively evaluate these rashes and when they occur. Doctors will also need to examine tissue samples to determine if the virus that causes COVID-19, known as SARS-CoV-2, can be detected in the skin itself, which is the case for some viral illnesses that cause rashes.”

The New York Times reported, that before the coronavirus outbreak, Dr Lindy Fox, a dermatologist in San Francisco, said she is used to seeing four or five patients a year with chilblains.

“All of a sudden, we are inundated with toes,” said Dr Fox, “I’ve got clinics filled with people coming in with new toe lesions. It’s not people who had chilblains before — they’ve never had anything like this.” She also mentioned, “Usually, we see it in the dead of winter.” 

Dr Esther Freeman, a dermatologist at Massachusetts General Hospital in Boston, told The Washington Post, “The inflammation tends to disappear without treatment in two to three weeks.”

So far, data shows that most people with so-called “COVID toes” are asymptomatic or have mild cases of the disease. “Moreover, this strange rash tends to affect the younger crowd, including children and adults in their 20s or 30s,” she said.

Medical papers from Spain, Belgium and Italy described a surge in complaints about painful lesions on patients, whether the patients were infected was not always clear, since they were otherwise healthy and testing was limited.

However, it is still too early to determine whether these rashes are certainly caused by our freedom stealer COVID, or whether there are other factors involved, which Dr Kanade Shinkai considers be to the million-dollar question.