Since the beginning of the coronavirus pandemic, health experts constantly discover new symptoms. The common symptoms of COVID-19 that are known in the public are fever, cough, shortness of breath, and chills, but some doctors have reported symptoms in some patients that are less obvious, including what is called "COVID toes" and other skin conditions.

COVID toes

The director of Global Health and Dermatology at Massachusetts General Hospital and an assistant professor at Harvard Medical School, Esther Freeman, said that "COVID toe" cases look similar to chilblains or pernio, which is a condition of inflamed blood vessels caused by cold temperatures.

Freeman said that they are seeing the inflammatory response that is normally seen when someone was exposed to the cold temperature, like when someone who has been playing outside with set socks. But, in the COVID-19 setting, experts are seeing it in warm climates and they are seeing it in patients who have been indoors and sheltering in place.

According to Freeman, it is not unusual for a virus to cause a rash, which is why dermatologists are not surprised that COVID-19 could cause skin symptoms. She said that what is surprising are the so-called "COVID toes" because it is a symptom that health experts have not seen in other viruses.

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Freeman has been seeing patients through telehealth video and said that aside from seeing skin symptoms in her own patients, she has also received examples of these symptoms from health care providers all over the world. Freeman said that "COVID toes" have been seen in both adults and children. They are usually present along with more typical coronavirus symptoms, and sometimes they are the only symptom the patient is showing.

Skin conditions linked to COVID-19

There are some physicians who also reported seeing skin conditions that look like morbilliform rashes, chickenpox, or hives. A team of dermatologists from Belgium and Oregon has also studied toe and skin infections in relation to COVID-19. In a case report that was published in JAAD, they stated that it is important for dermatologists to recognize the signs.

The researchers wrote about a man who had purplish and painful plaques on his toes and the outer side of his feet for three days. The 23-year-old man had a low-grade fever and dry cough several days before that.

After a skin examination, the said patient tested positive for COVID-19. The researchers noted that he has diagnosed with COVID-19 infection-induced chilblains, which is the medical term for skin sores. The same cases have been observed by Belgian and French dermatologists but had not been previously reported because of the lack of testing.

According to the study, young patients presenting with chilblains have lacked criteria sufficient to allow for a COVID-19 PCR test. Because of the outbreak of chilblains, concurrent with the increase of COVID-19 cases, COVID-19 has been widely suspected as the etiology.

The study looked at the COVID-19 chilblains cases in young adults and children, whose feet have been more affected than their hands. The chilblains may be the inaugural symptoms of COVID-19 and fever and dry cough may be minimal or even absent.

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