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What do we know so far about "COVID toes"?

This article was published on
April 21, 2021

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"COVID toes" typically refers to purple or pink discoloration, often with small, raised bumps on the skin on the tips of the toes and, in some instances, on the hands. Current research on the symptom is still evolving, and the exact cause of the symptom remains unclear. It is also important to note that multiple of the reports published about "COVID toes" are not based on patients having positive laboratory test results for COVID-19. The association with COVID-19 in these reports is based on the patients self-reporting COVID-19 symptoms or reporting having been in close proximity with someone diagnosed with COVID-19. The appearance of "COVID toes" and other symptoms can vary from patient to patient, and a dermatologist or clinician should be consulted for better clarity and safety in diagnosis. As of now, it is not clear what makes some people infected with COVID-19 have this reaction to the virus. It is not clear when in the course of illness the discoloration and rashes are most likely to be observed, and some reports suggest that these symptoms may occur more commonly in people without other typical symptoms of COVID-19.

"COVID toes" typically refers to purple or pink discoloration, often with small, raised bumps on the skin on the tips of the toes and, in some instances, on the hands. Current research on the symptom is still evolving, and the exact cause of the symptom remains unclear. It is also important to note that multiple of the reports published about "COVID toes" are not based on patients having positive laboratory test results for COVID-19. The association with COVID-19 in these reports is based on the patients self-reporting COVID-19 symptoms or reporting having been in close proximity with someone diagnosed with COVID-19. The appearance of "COVID toes" and other symptoms can vary from patient to patient, and a dermatologist or clinician should be consulted for better clarity and safety in diagnosis. As of now, it is not clear what makes some people infected with COVID-19 have this reaction to the virus. It is not clear when in the course of illness the discoloration and rashes are most likely to be observed, and some reports suggest that these symptoms may occur more commonly in people without other typical symptoms of COVID-19.

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What our experts say

"COVID toes" typically refers to purple or pink discoloration, often with small, raised bumps on the skin on the tips of the toes and, in some instances, on the hands. Current research on the symptom is still evolving, and the exact cause of the symptom remains unclear. It is also important to note that multiple of the reports published about "COVID toes" are not based on patients having positive laboratory test results for COVID-19. The association with COVID-19 in these reports is based on the patients self-reporting COVID-19 symptoms or reporting having been in close proximity with someone diagnosed with COVID-19. The appearance of "COVID toes" and other symptoms can vary from patient to patient, and a dermatologist or clinician should be consulted for better clarity and safety in diagnosis. As of now, it is not clear what makes some people infected with COVID-19 have this reaction to the virus. It is not clear when in the course of illness the discoloration and rashes are most likely to be observed, and some reports suggest that these symptoms may occur more commonly in people without other typical symptoms of COVID-19.

Context and background

There have been many reports of new and emerging symptoms linked to COVID-19 throughout the evolution of the pandemic. As healthcare professionals continue to learn about the virus and its presentation, classifying symptoms according to their severity and frequency has become important in making accurate and timely diagnoses. While the most common symptoms of COVID-19 are breathing problems, fever, coughing, and fatigue, other symptoms of infection have also been identified and include nausea or vomiting, diarrhea, sore throat, loss (or absence) of smell or taste, and muscle aches. 

Another symptom that has been occasionally reported is a discoloration (a slightly purple or pink color) or bumpy rash on the toes, feet, or hands- commonly referred to as “COVID toes.” Reports have continued to suggest that “COVID toes” are fairly uncommon, though they may occur more often in younger, asymptomatic patients. Healthcare professionals often suggest that patients contact their doctors for any unusual symptoms that they experience, and patients should seek medical care and coronavirus testing if they experience symptoms common to coronavirus infection.

Resources

  1. An editorial about the dermatological landscape of COVID-19 (JAMA)
  2. Are COVID Toes and Rashes Common Symptoms of the Coronavirus? (Cleveland Clinic)
  3. Chilblain-like lesions on feet and hands during the COVID-19 Pandemic (International Journal of Dermatology)
  4. Focus on "COVID Toes" (JAMA Dermatology)

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