There has been much interest in the research published, since the beginning of the coronavirus pandemic, regarding its effects on the skin. For podiatrists, the chilblain-like lesions colloquially termed "COVID toes" have been generated much discussion and debate which I have covered in previous articles on COVID nails and skin manifestations (COVID toes the mystery unravels), (COVID toes November 2020 Update). Recently a paper has been published which discusses how most of the published images showing the chilblain-like lesions on the toes have been in patients with Fitzpatrick skin types one and two with few on types three, four, and five - despite them being evident in all skin types. Consequently, they have published seven case studies with clinical images to illustrate how they may manifest. The authors note that recognition of such skin lesions in darker skin types can be difficult and lead to misdiagnosis and delays in treatment.
Cutaneous findings notes in patients at clinical presentation
(Source: Daneshjou et al., 2020)
The authors agree with previously published reports that most patients with these lesions test negative using standard COVID-19 PCR and serology testing despite a history of COVID exposure and symptoms.
The full paper and images can be downloaded here.
Reference
1. Daneshjou R, Rana J, Dickman M, Yost JM, Chiou A, Ko J: Pernio-like eruption associated with COVID-19 in skin of color. JAAD case reports 2020, 6(9):892-897.
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