4:13 PM, Feb 27, 2020


Dermatologists treat patients with COVID toes as more symptoms become known

Posted at 11:46 AM, May 06, 2020

The most common symptoms of COVID-19 in patients include shortness of breath, fever and a cough. A new, unusual symptom, though, is gaining widespread attention: COVID toes.

"All of us expected this to be a respiratory virus, and as it evolved, we realized there may have been other symptoms, as well, but we never would have thought that dermatology would be at the forefront with how some of these cases would present," said Dr. Jeffrey Fromowitz, a dermatologist at Dermatology of Boca.

Dr. Fromowitz treated a number of patients who have shown symptoms of what's being called COVID toes, a rash or swelling of blood vessels on the feet. He says along with respiratory infection in COVID-19 patients, a lot of inflammation is created in the body.

"We really started to biopsy these areas to look for a pattern. Have these patients tested for coronavirus? And low and behold, we were seeing in very many cases, these weren’t typical rashes, but rather, viral manifestations, so they indicated a coronavirus infection," said Dr. Fromowitz.

Dr. Fromowitz says he and other dermatologists are thankful that doctors in Europe, who first noticed the condition, informed their U.S. counterparts so they weren't caught off guard.

Many patients are surprised when they end up testing positive for COVID-19 because it was an isolated symptom for the novel coronavirus.

"It seemed really unlikely that I would suddenly get five or six blisters across all the tops of my toes from shoes I had worn before," says Derek Lyttle, who never got tested for COVID-19 but is sure he experienced this lone symptom of COVID-19. "They kind of went away after a week and then totally went away after two weeks. But as more and more stories came out it was, ‘Oh, this could be a symptom of COVID-19."

Though Dr. Fromowitz sees a range of skin conditions in his office, he and his staff are now keeping COVID-19 in mind when diagnosing patients.

"We're looking at anything that’s new, different or changing that doesn't have a good explanation. It's almost like, look, 'Let’s think of COVID-19 and get this patient tested.' And it speaks to why we’re doing universal precautions for everyone we see, because we don’t know how this presents," said Dr. Fromowitz.

While most people at first associated COVID toes with children, Dr. Fromowitz says he's seen it in patients young to middle-aged.