'COVID toes' reported in some patients with the coronavirus
Laying waste to lives and livelihoods, dividing people in regard to "opening up" states and economies, the coronavirus again looks to kick us when we're down.
With COVID toes.
Yes, COVID toes, a term given to discolored toes reported in some patients who have tested as COVID-19 positive.
"It kind of just happens out of the blue," said Dr. Jill Cotseones, a dermatologist with Northwestern Medicine Central DuPage Hospital.
"All of a sudden you're feeling well and then you might start to develop a reddish-purplish discoloration, like a tiny little spot on the toe that gets maybe a little bit bigger over the next few days and then starts to involve a few of the other toes as well," she said.
It's a discoloration similar to pernio, or the frost bite-like inflammation after exposure to cold environments. Though less common, fingers and hands also may be affected.
The good news? In and of itself it's not dangerous, Cotseones said.
"The skin lesions will just kind of resolve on their own with no treatments at all," she said. "I think what it's signifying, especially if it is in a younger individual, they may not have any other symptoms of the virus but it means that they may have the virus so they've really got to self-quarantine and be careful and protect that vulnerable population."
Cotseones has yet to see a case of COVID toes, initially linked to the coronavirus in data from China and Italy where COVID-19 first struck. But there is mounting evidence in the United States.
Other skin conditions are being reported in relation to the virus -- hives; a netlike red rash called livedo reticularis; a chickenpox-like eruption; and petechiae, red speckles normally seen in people with low platelets. Doctors caution that the presence of a skin condition does not necessarily indicate the patient has the coronavirus.
In a Today.com article, without dismissing a relationship, Temple University's Dr. Tracey Vlahovic said there's currently not a "one-to-one correlation" between toe discoloration and COVID-19.
With any information potentially valuable to battle this mysterious, evolving pandemic, everything is on the table. COVID toes are grabbing the attention of the dermatology community, including a registry of associated skin manifestations on the American Academy of Dermatology website.
"There's definitely cases in the United States," said Cotseones, noting that this one seems specific to COVID-19.
These lesions -- more common in children and adolescents, the University of Pennsylvania's Dr. Misha Rosenbach notes in an AAD article, do not indicate the severity of the illness nor are they a predictor of hospitalization.
COVID toes do seem to precede other symptoms of the virus, and may be the only symptoms a person presents. Because of that, it should be evaluated by a physician or dermatologist -- particularly if they persist or worsen, Cotseones said.
"I would love it if the people would reach out to a physician and ideally get tested," she said.
"If it's something that's persisting, it absolutely needs to be investigated by a doctor and we need to rule out other things, like autoimmune diseases or vascular disease.
"There's other causes," she said, "so I just want people to know that although, yes, right now we're going through this COVID pandemic, I don't want them to just think their toes are automatically related to that. They definitely need to be evaluated by a doctor."