What are “COVID toes”?
COVID toes is the term being given to the red-purple-blue discoloration that occurs on toes that has been reported in patients infected with the corona virus. They have been reported in both children and adults, and do not typically correspond to the severity of the corona virus infection. Typically “COVID toes” involves the first three toes and shows up as red-purple to blue skin lesions at the end of the toes. These lesions are often painful. As the infection progresses, the skin lesions can blister or form a crust on the skin, but usually improve within two weeks.
What causes COVID toes?
A lot is unknown about the the corona virus, but we are learning more each day. We know that there is an increased risk of inflammation in the blood vessels or clot formation in very sick patients with COVID-19. We suspect that this is secondary to the extreme immune response triggered by the virus which may result in damage to the lining of the blood vessels and clot formation. As a result, this may cause decreased blood flow of the skin surfaces at the end of the toes, leading to discoloration; although further investigation is warranted.
What are the treatments for COVID toes?
COVID toes are typically self-limited, meaning they heal on their own. The discoloration and lesions associated with COVID toes improve as the infection clears and no treatment is typically necessary. Sometimes a biopsy of the lesion may be necessary to differentiate COVID-19 skin lesions from other causes of skin lesions. COVID toes may be the first symptom of the COVID-19 infection, and therefore viral testing may be needed. There are some topical treatments that may be helpful if the lesions are especially painful.
What else may be causing discoloration of the toes?
Not all red-purple toes are “COVID toes” and therefore if you’re experiencing these symptoms, you should be evaluated by a physician. Similar skin lesions can be associated with chronic autoimmune or vascular disease, infection, or be suggestive of a medication reaction.
If you think you may be experiencing symptoms of the corona virus or COVID toes, it is important to contact your physical by phone for guidance in treatment and testing.
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