COVID toes: a new mysterious skin condition possibly linked to coronavirus

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President Donald Trump often refers to COVID-19 as the “invisible enemy” during daily Coronavirus Task Force briefings, however, new evidence is surfacing showing coronavirus may be a physical affliction as well. In addition to attacking the respiratory system, coronavirus may be attacking toes. Cases of a new mysterious skin condition that causes purple, blue or red discoloration of the toes, and sometimes the fingers, are popping up across the country, prompting dermatologists to wonder if there is a connection to COVID-19.

What are “COVID toes?”

Northwestern Medicine dermatologist Dr. Amy Paller reports seeing images of as many as 30 cases of “COVD toes.” Dr. Paller says this condition causes lesions, painful bumps, and sometimes frostbite-like areas of purple, blue, or red discoloration in toes and sometimes fingers. Dr. Paller says the lesions may be on one toe, or all of them, and can appear on the top or bottom of the foot. Dr. Ebbing Lautenbach, Chief of Infectious Disease at the University of Pennsylvania’s School of Medicine, tells USA today these lesions are typically painful to touch and can even have a hot burning sensation.

Who is most at-risk for “COVID toes?”

According to Dr. Paller, “COVID toes” appear to be striking primarily children and young adults. The lesions are being seen in people who are asymptomatic, or who have no other symptoms of coronavirus. Doctors say the “COVID toes” may be a warning sign of a coronavirus case. While more research is needed to define a direct link between coronavirus and “COVID toes” Susan Wilcox, Chief of Critical Care for the Massachusetts General Hospital tells USA Today she began seeing the purple lesions on the feet of people with severe cases of COVID-19. Wilcox suspects the lesions are caused by inflammation from a severe infection causing tiny blood clots in the feet.

How long do “COVID toes” last?

Health experts are finding each patient is dealing with “COVID toes” for various lengths. Dr. Paller says “COVID toes” appear to resolve spontaneously, while Dr. Wilcox reports seeing the lesions lasting for as long as 10 days.

Is there a direct link between “COVID toes” and coronavirus?

Dr. Paller said her team is not sure if there is a direct correlation because testing is limited. “There have been some children who have tested positive, there have been some children who have tested negative,” Paller said. “Most who have this have not had any testing and we’re waiting for antibody testing to come out … to further answer the question of the relationship with COVID-19.” Paller said parents should not necessarily act urgently if this is the only potential sign of the virus their child is showing. However, it is important to notice and document it with photos if more symptoms should appear. “None of these teens or young adults have gone on to have any serious issues,” she said. “They seem to resolve after a few weeks. We’ll have to find out more as this progresses.” Paller said it’s always good to consult a pediatrician with any concerns.

Other symptoms of coronavirus

While “COVID toes” may be an early indication of a looming coronavirus diagnosis, it’s important to be aware of the other symptoms. The U.S. Centers for Disease Control and Prevention (CDC) has these guidelines on what to watch out for when it comes to coronavirus. These symptoms may appear 2-14 days after exposure to the virus:

Fever

Cough

Shortness of breath or difficulty breathing

Chills

Repeated shaking with chills

Muscle pain

Headache

Sore throat

New loss of taste or smell

When to seek medical attention

If you develop any of these emergency warning signs* for COVID-19 get medical attention immediately:

Trouble breathing

Persistent pain or pressure in the chest

New confusion or inability to arouse

Bluish lips or face

How to stop the spread of coronavirus

With no end to the coronavirus pandemic in sight, it will likely be a long while before things return to normal. We can all do our parts to get ahead of the coronavirus spread by continuing social distancing, limiting contact with strangers, like takeout food drivers, standing at least six feet away from other people, wearing cloth masks in public, and proper handwashing techniques.

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