COVID-19 Toes

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COVID-19 Toes
 / Source: TODAY
By Maura Hohman

Have you heard of COVID-19 toes? The longer the novel coronavirus circulates, the more unexpected symptoms pop up.

To name a few, ophthalmologists have said pink eye may be a rare sign of COVID-19, and anosmia, or a loss of smell, can occur in patients with no other symptoms. Coughing blood and tingling all over the body have also been reported.

Now, another condition possibly linked to the coronavirus has captured researchers’ attention. Dubbed “COVID toes” by the dermatology community, it can look like “purple lesions” on feet or hands, Dr. Esther Freeman, a dermatologist at Massachusetts General Hospital in Boston, told TODAY.

The research is ongoing and rooted in “observation,” Dr. Tracey Vlahovic, associate professor of podiatry at Temple University in Philadelphia, told TODAY. “There’s no one-to-one correlation.”

But because COVID toes may appear before or without other coronavirus symptoms, Freeman believes it should be a criterion for testing. Dr. Lindy Fox, professor of dermatology at University of California, San Francisco, agreed.

What are ‘COVID-19 toes’?

The condition usually starts with red or purple discoloration, and the skin may become raised or develop ulcerations, according to Freeman. It can be on hands, too.

Fox told TODAY it has appeared as “purple, red bumps” on the tips of digits and pads, or on the tops of toes or sides of feet.

People with COVID toes may feel the skin is hot, burning or itchy.

One patient, David, 39, who didn’t want to share his last name, experienced possible COVID toes. He wasn’t tested for the virus, but told TODAY via email: “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.”

COVID-19 Toes
David, 39, said his condition, which appeared to be COVID toes, lasted for about a week. Courtesy of David.

While other skin symptoms have appeared in COVID-19-positive patients, this one seems “COVID-specific,” Fox clarified. According to a case report from the European Journal of Pediatric Dermatology, the condition has “never been observed in the past.”

What causes COVID toes?

Again, the research is just beginning, but experts have some ideas.

“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.”

Concerned you may have Covid Toes? Call Houston Foot and Ankle Care and let us know your concern. We offer video visits.