Symtomps of COVID-19 on skin?

May 3, 2020

Today, there were around 3.51M people around the world confirmed of getting infected by COVID-19. A third of those were recovered and nearly 250K deaths. After four months, more evidence has been collected. The previous common known symptoms are fever, tiredness and dry cough. Some others could be aches and pain, nasal congestion, runny nose, sore throat, diarrhoea. A few uncommon could be a loss of smell and scene.

Recently, a group of dermatologists in Belgium and the US has detected a new symptom on skin from a young male case study. It calls attention from the community. More and more evidence is found across the countries.

Overall statistics

Published on 28/2 in the New England Journal of Medicine, in China, among 1000 COVID-19 patients, only 0.2% of those show rashes.
In Italy, among 150 COVID-19 patients, up to 20% of hospitalization was found.
Published on 26/3 in the Journal of the European Academy of Dermatology and Venerology, there is a conclusion of dermatologist about subtle skin changes.

Case study

On March 8, a 13 year-old-boy developed lesions initially thought as a spider bite, but then diagnosed with COVID-19.
Published on 6/4 on a press communication publisher, COVID toes was first recognized by a report of a French dermatologist.
Published on 8/4 in the Spanish General Council of Official Podiatrist Colleges release a statement about numerous cases found in Italy, France and Spain.

Observations

It could take many forms such as tiny dots, larger flat or raised lesions; hive like appearance while frostbitten toes in COVID-19 cases
In a young population: children or in their 20-30s with good health conditions.

Prior studies on other viral disease:

Rashes are commonly observed among viral illness, e.g. chickenpox, measles and hand, foot and mouth disease can cause rashes, mostly in children.

What we know

Patients with COVID-19 toes are reported with mild or asymptomatic cases.
Too early to say about a causality whether it is caused by a virus or a reaction pattern of ramped-up immune system caused by any disease . What we know is a sudden increase in the number of case reports.

Unknown questions

The statistical significance of rashes towards an outcome of patients in a positive way or negative way.

What really happens

More discussion in the science community with more rigorous methodologies to measure and assess a link between observation and underlying mechanism.

What is looking for next?

American Academy of Dermatology: More evidence reported by dermatologists via an online registry of 300 patients this week.
Update(6/5): There was more than 400 reports from 21 countries. A half of those are cases of COVID toes.

I am building an app for skin analysis on top a privacy technology. Welcome to any thought and advice if you would like to share. Feel free to send me an email to emma@blueskinx.com