For some survivors, “COVID Toes”, the rash can last for months-consumer health news

Monday, November 2, 2020 (HealthDay News)-For some patients, COVID toes and rashes can persist long after recovery from the coronavirus, new studies show.

The frequency with which skin problems are associated with COVID-19 is unknown, but some patients (so-called “long-haul carriers”) get better, but do not appear to have fully recovered. For these patients, skin symptoms last for more than 60 days, according to researchers.

COVID toe and skin rashes are a sign of inflammation, said Dr. Esther Freeman, senior researcher at the COVID-19 Dermatology Registry, a joint effort of the American Academy of Dermatology and the International Society of Dermatology.

“Some patients have long-term inflammation that is somehow caused by the virus,” she said. “I’m still not sure exactly why and how this is happening, but it’s especially interesting and important because the skin can be a window to what’s happening in other parts of the body. Look at the inflammation that is actually happening, because it is visual to. “

Freeman speculates that these skin problems are a sign of the immune system’s response to the virus.

Using dermatological registration data, researchers examined about 1,000 skin rashes among people with COVID-19.

“I think it’s important to understand that this may be the tip of the iceberg when it comes to skin. It’s probably underreported,” Freeman said, and the registry has all COVID-19 cases where skin conditions occur. Said that it does not cover all. ..

Researchers reported that redness and swelling of the feet and hands (also known as COVID toes) lasted a median of 15 days in patients suspected of having coronavirus infection and 10 days in laboratory-confirmed cases. did. That is, half of the cases lasted a long time and half were short-lived.

However, according to the report, of the six long-haul carriers with COVID toes, symptoms lasted 60 days, and two patients had symptoms for more than 130 days.

The median hive-like rash lasted 4 days, and the so-called measles-like rash lasted 1 week. The maximum period was 28 days.

The median squamous cell carcinoma of the papules, which are scaly spots on the skin, lasted 20 days, with one case lasting 70 days, the study showed.

Dr. Michele Green is a dermatologist at Lenox Hill Hospital in New York City. “These dilated skin symptoms are the result of the body’s violent inflammatory response to COVID-19,” she said.

She pointed out that the skin is the largest organ in the body and plays an important role in regulating body temperature, sensation, and immune defense.

“It’s not surprising to me that such a toxic virus, which releases so many cytokines in the body, has a profound reaction and expression on the skin,” Green added.

According to Freeman, in addition to the visible signs on the skin, the toes of COVID can also be painful. The discoloration usually lasts for a long time, but the pain and discomfort lasts for about a week.

“Most of my patients I have taken care of report discomfort with toe swelling and toe pain, usually for about a week, even if the lesion itself may last for weeks.” Freeman said. “My patient says it’s so uncomfortable that I can’t put on my shoes.”

For most patients, the condition disappears spontaneously. But in the few cases, it lasts long.

“Unfortunately, some of our patients in this long-lasting group experienced long-term discomfort, so some of our patients had their feet all the while actually experiencing it. I was feeling pain and discomfort. These long-distance carriers, “Freeman said.

She added that treatment is a challenge and there is no protocol. “We are working on it,” Freeman said. “I think all my patients want the answer.”

She fears that some patients will have a long-lasting effect of COVID-19.

“Sure, there is a risk that some patients may continue to have skin problems with COVID-19. Our job is to figure out why this is happening and how to treat them. Is to figure out, “she said.

The findings were presented Thursday at an online conference of the European Academy of Dermatology and Sexually Transmitted Diseases. Studies presented at conferences are usually considered preliminary until published in a peer-reviewed journal.

For more information

For more information on COVID-19 Centers for Disease Control and Prevention.

Source: Esther Freeman, MD, PhD, Principal Investigator, COVID-19 Dermatology Registry, and Director of Global Health Dermatology at Massachusetts General Hospital and Harvard Medical School Boston.Michele Green, MD, Dermatologist, Lenox Hill Hospital, New York City; European Academy of Dermatology and Sexually Transmitted Diseases Conference, Virtual Conference, October 29, 2020