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Foot Lesions May Be a New Symptom of COVID-19

The pre-symptomatic detection of COVID-19 can be difficult since some people get the disease without showing any signs of the virus. But health experts in Europe have found a correlation between discolored patches on the feet and toes of patients who eventually started showing symptoms of COVID-19 and these markers may be a clue to identifying a coronavirus infection.

Purple-Colored Patches on the Toes and Feet

In April doctors in Spain, Italy and France reported that a number of patients who tested positive for COVID-19 appeared with small lesions on their feet, which could be a potential symptom of the virus. The General Council of Official Colleges of Podiatrists in Spain reported "registering numerous cases of sick people, mainly children and young people, who had dermatological lesions on their feet”. First citing the case of a 13-year-old-boy who was examined because of purple-colored patches on the top of his toes and feet. Thought at first to be a spider bite, the lesions were similar in appearance to those of chickenpox, measles or small lesions that appear after exposure to very cold temperatures on the distal extremities of the foot. Two days later, the boy presented with general COVID-19 symptoms.

Other podiatric, infectious disease specialists and dermatology groups have also reported a correlation between the toe lesions as a potential sign of a coronavirus infection. Dr. Ebbing Lautenbach, chief of infectious disease at the University of Pennsylvania’s School of Medicine reported that the lesions may be an early manifestation of the disease, saying that sometimes this might be your first clue of COVID-19 before other symptoms appear. In some patients, the red or purple-colored patches know as “COVID toes” can disappear with no other symptoms of the virus after a week or so, other patients have come down with serious respiratory problems.

Criteria for Testing

Not yet a confirmed symptom of COVID-19, meaning it’s not totally clear whether the foot lesions are definitely related to COVID-19. As a symptom becoming more commonly seen and occurring in otherwise asymptomatic or mildly affected patients, they are significant. Experts believe it seems "too much of a coincidence not to be a manifestation of the virus for patients in their teens and 20s”. In most cases, the lesions appeared in teenagers and children that contracted the virus. A definitive one-to-one correlation between purple-colored patches on the toes and feet and COVID-19 needs to be further explored and because "COVID toes" may appear before or without other coronavirus symptoms, medical experts believe it should be a criterion for testing.

Unusual Skin Changes Require Follow-Up

As the situation surrounding COVID-19 continues to evolve it is important to note any unusual changes in your body including changes as described above in skin texture or color of the lower extremities. Before self-medicating with topical corticosteroid creams it is important to consult with your doctor if you are experiencing any of the above symptoms. Any unusual changes on the skin surface of the lower extremities can be significant and should be followed up with your podiatric physician or health care provider.

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