In a new study, researchers found skin signs of COVID-19 can range from purple toes, known as “COVID toes” seen in patients with mild infections, to a net-like rash signaling the presence of life-threatening blood clots in patients with severe disease.
Certain skin changes may also be the only sign of COVID-19 infection or may accompany or follow other COVID-19 symptoms.
The research was conducted by a team at Massachusetts General Hospital (MGH) and Harvard Medical School (HMS).
In the study, the team collected information on 716 cases of new-onset dermatologic symptoms in patients with suspected COVID-19 infections, including 171 patients with infections confirmed with laboratory testing.
They did not see that COVID-19 causes one particular rash, but rather that it’s causing a variety of rashes.
They found that among all lab-confirmed patients, the most common skin sign was a measles-like (morbiliform) rash in 22% of patients that were generally seen in patients with moderate infections, followed by so-called “COVID toes” (pernio-like reaction) consisting of red or purple itchy or tender bumps on the toes, heels or fingers, typically seen when the skin is exposed to cold air or surfaces.
This reaction was seen in 18% of patients in the registry and was generally associated with mild infections.
In contrast, retiform purpura, the aforementioned net-like rash usually caused by blood clots in small vessels, occurred in 6% of patients, all of whom were hospitalized and critically ill.
The team says while most of the rashes are occurring at the same time as or after other COVID symptoms, 12% occurred as the first or presenting sign of COVID-19.
That’s important to be aware of because if people do have a rash that’s unusual or might fit one of these categories and they don’t have another reason for having it, that would be a reason for talking to health-care providers.
One author of the study is Esther E. Freeman, MD, Ph.D., an investigator in the Department of Dermatology at MGH and HMS.
The study is published in the Journal of the American Academy of Dermatology.
Copyright © 2020 Knowridge Science Report. All rights reserved.
