Some ‘long-hauler’ COVID-19 patients suffering from prolonged skin symptoms

TORONTO — A new study has found that some ‘long-hauler’ COVID-19 patients, who experience persistent symptoms months after infection, suffer from prolonged skin problems including various rashes and painful lesions on the hands and feet dubbed “COVID toes.”

The analysis looked at the largest global registry of COVID-19 patients with dermatological symptoms and found that ‘long-hauler’ COVID-19 patients can experience skin symptoms more than 60 days after infection.

The dermatological registry is a collaboration between the International League of Dermatological Societies and the American Academy of Dermatology. Data from 990 COVID-19 cases spanning 39 different countries has since been logged in the registry.

The analysis found that dermatological symptoms of COVID-19 on average last 12 days, but can persist for up to 150 days in some patients.

The findings were released on Thursday at the annual European Academy of Dermatology and Venereology (EADV) conference.

According to the findings, the length of skin symptoms varied depending on the dermatologic manifestations.

The analysis reported that ‘long-hauler’ COVID-19 patients with hives or urticarial found the symptom lasted for a median of five days, while papulosquamous eruptions, also known as eczema or rosea, persisted for 20 days.

Symptoms of pernio or chilblains, more commonly known as “COVID toes,” lasted for 15 days, but in some cases the symptom persisted as long as 130 to 150 days.

According to the research, “COVID toes” patients with symptoms lasting long after the acute phase of COVID-19 may have implications for understanding the “prolonged inflammatory response” in some patients after infection.

While “COVID toes” often appear 1-4 weeks after initial infection, 15 per cent were found to still be PCR positive for COVID-19 after the fact.

The analysis also found that skin symptoms varied by COVID-19 severity.

Some skin symptoms, such as retiform purpura or skin lesions, were associated with severe cases of COVID-19 since 100 per cent of patients with this symptom were hospitalized, according to the study.

In contrast, the analysis reported that “COVID toes” are associated with relatively mild infections with only 16 patients with the symptom being hospitalized.

Dr. Esther Freeman, principal investigator of the International COVID-19 Dermatology Registry, said the findings highlight the need for further research into the dermatological symptoms of COVID-19 and the interaction between COVID and underlying skin conditions.

“This data adds to our knowledge about how COVID-19 can affect multiple different organ systems, even after patients have recovered from their acute infection. The skin can provide a visual window into inflammation that may be going on elsewhere in the body,” Freeman said in a press release.

The EADV says the world is learning more about COVID-19 every day, and skin symptoms of the disease are just starting to be understood and explored.

An EADV survey previously revealed that 35 per cent of dermatologists saw patients presenting skin-signs of COVID-19. Of the 490 dermatologists surveyed, four per cent of them later tested positive for COVID-19 after evaluating such patients.

The EADV said the survey results stress the importance of using personal protective equipment including face masks during dermatological consultations amid the pandemic.

While research into the dermatological symptoms of COVID-19 continues, the EADV said it is also investigating a possible association between male pattern baldness and men hospitalized with COVID-19.

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