As the COVID-19 pandemic continues, doctors and researchers are learning more about the behavior and effects of the virus. We’re all aware that it’s a mainly respiratory illness; common symptoms include fever, coughing, and shortness of breath (if you have these, call your doctor please!). But more and more patients are exhibiting an unexpected symptom: skin rashes. We caught up with dermatologist Sandra Lee, MD (aka Dr. Pimple Popper), to find out more about these rashes, why they’re popping up, and when you should see a doctor.
We are still learning every day about skin manifestations of coronavirus. I think it’s proving to be a true chameleon, with different skin findings in different people. It’s not unusual for a viral illness to have an accompanying skin rash. Sometimes the rash is unique and clues you into the diagnosis, like chickenpox rash or herpesvirus rash. However, the rashes we are seeing in coronavirus can occur in other medical conditions as well.
We suspect many of the respiratory or lung issues may have to do with problems with blood clotting, especially in the small blood vessels in the body. Similarly, many of the skin findings we are seeing that we strongly suspect may be tied to COVID-19 are due to blood clots in our vessels. Because this happens to the more superficial blood vessels, we can see evidence of this in the skin, such as a frostbite-type appearance to fingers and toes and a reticular or net-like patterned rash in the skin.
We now have a term, “COVID toes,” that we use to describe the purplish/red slightly firm raised bumps that we are seeing occur on fingers and toes. This is seen in another condition called pernio, which can be seen independent of viral illness like coronavirus. However, it can be a sign of a hypercoagulable state, where you may develop small clots within your blood vessels. This cuts off proper blood supply to your fingers and toes, causing them to turn purple in color.