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Doctors around the world are reporting that some patients diagnosed with COVID-19 develop skin rashes, including a frostbite-like rash on the feet dubbed “COVID toes.”
It’s certainly not unheard of for viruses to trigger skin rashes, however. Measles, chickenpox, and herpes are examples of viral infections with distinctive rashes — the result of the inflammation caused when the immune system fights the infection within the skin’s cells. COVID-19 could generate a similar skin reaction in some patients.
Five types of rashes
In a peer-reviewed paper published last week in the British Journal of Dermatology, a group of Spanish researchers described five different categories of rashes among COVID-19 patients. They came up with those categories after asking dermatologists in Spain to report details of any rashes they had observed in their COVID-19 patients within the previous two weeks. The dermatologists submitted 375 case examples.
Here are the five types of rashes they identified from those cases:
toes). These rashes, which occurred in 19 percent of the Spanish cases, were often itchy and/or painful. They primarily affected younger COVID-19 patients and were associated with mild infections. The rash tended to appear later in the illness and lasted an average of 12 days.
In case studies published in the April 30 issue of JAMA Dermatology, doctors identified two additional types of skin conditions that may be associated with COVID-19: petechiae (tiny purple, red or brown spots caused by bleeding under the skin) and a scaly rash called digitate papulosquamous.
More questions than answers
Again, it’s too early to know if COVID toes or any other rash is actually caused by the coronavirus.
“Early reports about the cutaneous [skin] eruptions seen in patients with COVID-19 raise more questions than they provide answers,” write three American dermatologists, including Dr. Kanade Shinkai, editor-in-chief of JAMA Dermatology, in an editorial that accompanied the case studies.
“The significance of a cutaneous eruption associated with COVID-19 remains unclear, especially as it pertains to prognosis,” they add. “It will require additional study to determine if specific host or pathogen factors contribute to the likelihood of developing a rash, and especially a specific pattern of rash.”
By Susan Perry | 05/06/2020