Northeast Ohio Researchers Examine "Covid Toes," Other Skin Symptoms

Emerging data from COVID-19 cases show skin symptoms are potentially associated with coronavirus infection.

Cleveland Clinic dermatologists Drs. Sarah Young and Anthony Fernandez recently published a study detailing several common skin symptoms in COVID-19 patients, such as hives and rashes. They looked at research from Europe.

Fernandez said he's seen some of these symptoms in patients at the Cleveland Clinic as well.

"It's actually quite common for viral infections to cause skin abnormalities or skin eruptions," Fernandez said. "This has been known for decades."

Of all of the conditions, Fernandez said there’s quite a bit of evidence for what’s now being referred to as “COVID toes,” or small red blisters on fingers and toes. He said this symptom seems to have occurred mostly in younger people.

"With time, what we need to do is incorporate into our practice what this means and what our actions are going to be," he said. "So, does that mean we should perhaps be testing older individuals in that household right away to see if they’ve been exposed to the virus and may be in an asymptomatic phase?”

Fernandez said more research is needed to determine the value "COVID toes" and other skin manifestations could have for treatment and prevention of future COVID-19 cases.

“If we can accumulate enough cases and enough of these different rashes that have been reported, we may be able to make sense concerning if any of them can be used as clues to diagnosis, or if seeing a certain type of rash may imply that that patient is much more likely to have a bad disease course and become intubated," he said.

One study he's proposed would gather data through pictures of COVID-19 patients with skin abnormalities in the ICU.

"What we're trying to figure out is, how can we capture as many of these cases as possible, to get an idea, really, about ... how many of these cases are developing into these manifestations," Fernandez said. "The truth is, we do not really know, because we have not been able to systematically evaluate every patient with COVID-19 to really get a true sense of how often these different rashes are occurring."

The Centers for Disease Control and Prevention does not currently recognize any skin conditions as symptoms for COVID-19.

The paper was published in the Cleveland Clinic Journal of Medicine.

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