Purplish Lesions On Feet Could Be Sign Of Virus, Say Dermatologists

Doctors say "COVID toes" could be a way to track the coronavirus in otherwise asymptomatic patients.

Dermatologists say looking at a person’s feet may be a handy way of seeing if someone has the coronavirus.

It seems that many otherwise asymptomatic people are reporting the presence of painful purplish lesions on their toes.

The so-called “COVID toes” are “typically painful to touch and could have a hot burning sensation,” Dr. Ebbing Lautenbach, chief of infectious disease at the University of Pennsylvania’s School of Medicine, told USA Today. “This is a manifestation that occurs early on in the disease, meaning you have this first, then you progress. Sometimes this might be your first clue that they have COVID when they don’t have any other symptoms.”

Lautenbach said for some people, “COVID toes” disappear without showing up with any other symptoms after a week or so, while others come down with serious respiratory problems.

In order to track whether the toe lesions are a true indicator of COVID-19, the disease caused by the virus, the Academy of Dermatology has launched a registry to track all the dermatological effects that COVID-19 patients may be experiencing.

Dr. Esther Freeman, a dermatologist and epidemiologist at Massachusetts General Hospital and a Harvard Medical School faculty member, told Business Insider that there are three main theories about “COVID toes:”

Some experts think the lesions are a sign the virus is causing general inflammation in the body, while others think the virus is inflaming the walls of the blood vessels, a condition called “vasculitis.”

A third theory is that the lesions are caused by blood clots in vessels in the skin. Blood clots may be a complication of the virus.

Current reports suggest that “COVID toes” more commonly appear in children and young people, but are “not exclusive” to them, Dr. Lindy Fox, a professor of dermatology at the University of California at San Francisco, told Today.com.

She suggests people with the condition get both a test to see if they’re infected as well as an antibody test to see if they previously had the virus, even if they’re not reporting any other symptoms.

Since “COVID toes” resemble “frostbite,” some dermatologists are treating the condition the same way.

“We tend to treat it by addressing the discomfort and trying to dilate vessels with [blood pressure] medications like nifedipine, for example,” Dr. Amy Paller, chair of the Department of Dermatology at Northwestern University Feinberg School of Medicine, told Yahoo. “And of course in that situation, trying to really keep the hands and feet warm.”

However, since frostbite commonly occurs during the winter season, Paller admits the current treatment method may not be ideal.

“You know, our usual technique of trying to keep things warm is probably not going to do much here,” she admitted.

Experts are still learning about the novel coronavirus. The information in this story is what was known or available as of press time, but it’s possible guidance around COVID-19 could change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.

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