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Tracking "COVID Toes" and Dermatologic Symptoms of COVID-19

In This Article

  • A dermatologic symptom of COVID-19, known as "COVID toes," has garnered significant media attention in recent weeks
  • Esther E. Freeman, MD, PhD, director of Global Health Dermatology at Massachusetts General Hospital, explained what is known about this symptom and other dermatologic symptoms
  • She described the international registry that dermatologists are using to track symptoms, which includes data from patients with lab-confirmed cases of COVID-19 as well as patients with suspected infection

Ongoing research has led to the identification of COVID-19 symptoms that were previously unrecognized, leaving experts with more questions about potential manifestations of the virus. In recent weeks, a symptom dubbed "COVID toes" has been described by patients with COVID-19 who experience skin lesions on the toes or hands.

In an interview with HealioEsther E. Freeman, MD, PhD, director of Global Health Dermatology at Massachusetts General Hospital, discussed the COVID toes condition and explained how she is working to track all dermatologic symptoms of COVID-19.

What Are COVID Toes?

The term refers to the emergence of red or purple tender bumps on the toes or hands, along with a painful burning sensation. Dr. Freeman noted that the symptom looks similar to a condition called pernio, a response to cold temperatures that affect the skin in the same way.

Dr. Freeman said the skin lesions have been observed in young and relatively healthy patients of all ages, and they seem to disappear in two to three weeks after virus infection. She recommended that dermatologists consider the risk of viral transmission when counseling patients who report the symptom, as people may develop lesions while they are still infectious.

More research is necessary to determine the point in the disease course at which a patient might develop COVID toes. Dr. Freeman states that more data is needed on the timing of these lesions to help guide providers on how to counsel patients.

Symptom Tracking in a Dermatology Registry

As a member of the American Academy of Dermatology's COVID-19 task force, Dr. Freeman contributed to the creation of an international registry that tracks reported dermatologic symptoms among infected patients.

While COVID toes have received more attention in the news, Dr. Freeman noted that about half of the registry includes other dermatologic conditions such as morbilliform, also known as measles-like eruptions, and urticaria, also known as hives.

The primary goal of the registry to collect dermatologic manifestations of COVID-19 from patients with lab-confirmed cases and patients with suspected cases of the virus. Additionally, researchers will track dermatologic symptoms in two groups of patients: 1) patients with preexisting dermatologic conditions, and 2) patients on existing dermatologic medications.

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Learn more about Global Health Dermatology at Mass General

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