The signs and symptoms of the coronavirus that has been declared a pandemic by the World Health Organisation vary widely. While some remain conspicuously asymptomatic others suffer pneumonia-like conditions that can turn fatal.
However, a little-known-about symptom is now being discussed in dermatology circles called ‘COVID toes’. It’s a condition that sees chilblain, or frostbite-like purple welts appear on the hands or feet of people who may otherwise show no symptoms of COVID-19.
Who were these bumps most noticed in?
Younger people, including children.
Where was the phenomenon first noticed?
In Italy, Dr Sanober Amin, dermatologist at Grapevine TX, was quoted as saying by Dallas-Fort Worth News.
Are these lesions a confirmation of COVID-19?
Fox News quoted Dr Amy Paller, chair of the Department of Dermatology at Northwestern University Feinberg School of Medicine, as saying she has recently seen a large number of teen and young adult patients with lesions, or painful bumps, on their toes.
“Sometime itchy, often times painful,” she was quoted as saying. “These are individuals who are often without any other sign of viral infection. We are seeing this in unprecedented numbers during the COVID pandemic.”
However, since testing is limited, these lesions are not conclusive.
“There have been some children who have tested positive, there have been some children who have tested negative,” Paller said. “Most who have this have not had any testing and we’re waiting for antibody testing to come out … to further answer the question of the relationship with COVID-19.”
That said, some skin experts, like Dr Esther Freeman, a dermatologist at Massachusetts General Hospital in Boston, have been quoted by US media calling on the establishment of the welts as a criterion for testing.
Are these lesions painful?
“They’re 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, was quoted as saying to TV station Wifr 23.
“COVID toes” in some people can disappear in the course of a week to 10 days, but others progress to respiratory symptoms, Lautenbach added.
A 39-year-old possible patient was quoted by Today as saying: "The affected toes were initially painful to touch and a bit sore while walking ... The pain and soreness lasted just over one week and gradually went away."
What could be causing it?
"One hypothesis is there's just a lot of inflammation caused by the virus," Freeman said. The condition resembles pernio, caused by exposure to cold temperatures, resulting in inflammation, which can appear as skin sores or bumps.
The other theory is that the symptom is due to blood vessel clots, which can occur in COVID-19 patients.
"I don't feel comfortable saying it's one or the other," Freeman explained. "It could be a bit of both."