COVID-19 Symptoms: Dermatologists Are Reporting New Clinical Manifestations Besides Skin Rashes Such As ‘COVID Toes’
Source: COVID-19 Symptoms May 05, 2020 4 years, 6 months, 1 week, 2 days, 2 hours, 8 minutes ago
COVID-19 Symptoms: Thailand Medical News had originally reported of skin rashes appearing in infected COVID-19 patients and also in asymptomatic and recovered patients as early as 24
th April.
https://www.thailandmedical.news/news/warning-covid-19-clinical-care-certain-strains-of-sars-cov-2-coronavirus-also-causes-skin-eruptions-in-covid-19-patients
However dermatologists and also medical experts are reporting new research studies that show it can also cause frostbite-like patches on the hands and toes, and rashes on the body.
https://jamanetwork.com/journals/jamadermatology/fullarticle/2765613
Credit: Journal of the American Academy of Dermatology
This new clinical manifestations are being reported occurring on not only hospitalized COVID-19 patients but also in those that have recovered or those that are asymptomatic. It also seems to also accompany certain strains of the SARS-CoV-2 coronavirus.
The new condition has been dubbed "COVID toes."
Dr Esther Freeman, director of Global Health Dermatology at Massachusetts General Hospital in Boston told Thailand Medical News, "One of the more surprising findings in this epidemic has been the lesions that we are seeing on people's toes and hands."
Dr Freeman noted that COVID toes are not caused by exposure to cold, as is frostbite or chilblains. Rather it seems to be an inflammation of the circulatory system that shows up as a skin rash.
These clinical manifestations of COVID toes do not just happen to children, as some have believed, as lots of adults also get them.
Skin rashes are not always associated with viruses, but measles, herpes and chickenpox and also in certain HIV conditions, skin eruptions are the main symptoms, so it is not unheard of.
Doctors are not able to comment as to how common COVID toes are because the data that would include the number of cases of COVID-19 and COVID toes doesn't exist. However Dr Freeman is compiling a registry of known COVID toe cases.
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Dr Freeman says she is seeing a lot more cases than usual. She said, "In addition to running the registry, I see patients myself through tele-dermatology at Massachusetts General Hospital, and I have seen more toes in th
e past two weeks than I have in the rest of my career."
If you have what you think might be COVID toes, the best thing to do is contact your doctor or dermatologist, she added.
Dr Raman Madan, a dermatologist at Northwell Health Huntington Hospital, New York said, "COVID toes is the most common finding I have seen in patients via tele-dermatology. It is a fairly new symptom that we usually do not see with a lot of viruses."
Normally the condition would result from being out in the cold for a long time or having a rheumatologic problem, he said.
Dr Madan added, "With COVID-19, I have been seeing it in a lot of young, healthy people. There is still a lot to be learned."
A lot of patients have been asymptomatic aside from the toes and have been testing negative on their viral culture, but positive on their antibody test.
He further added, "This has led me to believe that this may occur at the convalescent stage of illness, meaning after the body has cleared the virus. We are still working on the best guidance to give patients."
In one recently reported case, medical researchers described a patient in Wuhan, China, with COVID-19 who developed a rash on the torso. The researchers believe the rash was caused by an immune response to the virus and the patient tested positive for the Epstein-Barr virus, which has been tied to COVID-19. The rash disappeared within a week, but the patient died from COVID-19.
In another case, a Spanish man suffering from COVID-19 developed a rash on his thighs and buttocks. The rash went away after five days and the patient left the hospital after 12 days. The researchers assume that the rash was a reaction to the virus.
https://jamanetwork.com/journals/jamadermatology/fullarticle/2765614
Lead researcher Dr Borja Diaz-Guimaraens, from the dermatology department, Ramony Cajal University Hospital in Madrid, Spain a said, "Dermatologists should be aware that patients presenting with this kind of rash, in addition to coughing and fever, could benefit from COVID-19 testing."
He added, "We are starting to notice more extra-respiratory manifestations in patients with confirmed COVID-19, and increased awareness for those signs can help diagnosis."
Many medical researchers are speculating that the SARS-CoV-2 coronavirus is rapidly evolving and new mutated strains are emerging that are far more potent and virulent and that are attacking the human host in newer ways hence newer clinical manifestations.
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