Many of the typical symptoms of a COVID-19 infection have been well-documented and publicized since the initial days of the pandemic, such as fever and breathing difficulties. As the pandemic has progressed, new details have become available on less well-known manifestations that may affect the skin. The myriad of potential skin manifestations that may represent an active or recent COVID-19 infection are expanding in the scientific literature. And while it appears that there are not yet any identifiable skin manifestations that may be used in the diagnosis of COVID-19, there are several examples of skin changes that may be concerning. The following list is to help keep you, our valued patients, informed about how your skin may be a window to a potential concern on the inside.
This list represents a few examples of skin rashes in COVID-19 patients that have been reported in the literature to date. Please note that these findings have not yet been studied in a way that controls for potential confounding variables (such as patients potentially having medication reactions, or other ailments arising in the setting of COVID-19).
COVID Toes
“COVID Toes” represents a purple-like change to the most distant portion of the toes, feet, or fingers. This manifestation is believed to be the result of abnormal blood flow due to the virus’s ability to cause vascular ‘sludging’ or a coagulopathy (abnormal clotting of blood).
Image courtesy of Adam Luber, MD
Viral Exanthems
Viral Exanthems are rashes commonly associated with several viral infections, primarily of the upper respiratory tract. These rashes vary greatly but may present as a pink speckled rash over the trunk and extremities, or a very slightly scaly thin plaque-type rash, often in oval shapes, also over the trunk or extremities. There is a hypothesis that some of these eruptions are now also arising in patients with, or having recently recovered from, COVID-19.
Image Courtesy of Dermatology Advisor
Livedo Eruptions
Livedo Eruptions are usually large patch-like presentations of pink to purple skin changes shaped similarly to the branching of blood vessels. There are various forms of the changes, some that present transiently, and others that last for days.
Image courtesy of Lindsay Ackerman, MD
What Should I Do if I Have Symptoms Similar to These?
With the significant amount of information in the press and social media, we want to be a resource to help you determine when it is appropriate to consult with a dermatologist. If you have any concerns related to the skin issues described above, please call one of our offices to schedule a teledermatology visit so that we can determine the appropriate next steps for your care. Please note we are not conducting COVID-19 testing in our offices but may be able to help determine if COVID-19 testing is appropriate.
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