New Delhi: A teenager in Scotland couldn’t wear shoes because her feet would swell up. “I get blisters all over them and they go from pink to purple really quickly. I get lumps on the bottom of them which makes it really hard to stand up for long. I can only wear flip-flops,” she told BBC Scotland’s The Nine.
Among the various effects of COVID-19, many have reported ‘COVID toes’ or cases where ulcer or necrosis occurs on the tip of a toe and the neighbouring toe.
What are COVID toes?
COVID toes can develop on both the hand fingers and toes. According to news-medical.net, it appears to be more common on the toes and begins with a bright red colouration on the fingers or toes, which then gradually turns purple. It can start from one toe and affect all the toes.
“Covid toes are a recently-recognised symptom of Covid and can last anywhere from 10 to 14 days to many months. Usually, there is a discoloration of the toes and the toes become red or purplish and there may be some itching associated with it. But usually, there is no pain in the toes, but sometimes there can also be a presentation of pain which may become so severe that the patient is not able to wear his shoes,” Dr Shuchin Bajaj, founder-director, Ujala Cygnus Group of Hospitals told The Indian Express (TIE).
What are the causes?
News-medical.net says many of the patients who have so far been reported to have COVID toes have not had many other symptoms of COVID-19. Those that have had symptoms have had a mild fever or congestion and have been predominantly younger patients. It states that as per a proposed mechanism by Kolviras et al., Covid toes could be an antiviral immune response implemented by younger immune systems that results in microangiopathic (small blood vessel disease) changes.
Alternately, the condition may not be a direct result of COVID-19, reported medicalnewstoday.com. The condition is due to lifestyle changes brought on by the lockdown, such as walking barefoot in homes; inactivity, and increased time spent in sedentary positions, the site states.
What are the symptoms?
COVID toes are mostly painless but the discolouration makes it noticeable. For many others, it can also cause blistering, itch, and pain. There could also be a build-up of pus under the skin, Dr Nandini Barua, senior consultant dermatology, Paras Hospitals, Gurgaon, was quoted as saying by TIE.
“We feel strongly these symptoms are connected to the virus,” Lindy Fox, MD, a dermatologist and a professor of clinical dermatology at the University of California in San Francisco and a member of the COVID-19 task force at the American Academy of Dermatology (AAD) was quoted as saying by Everyday Health.
When it began to appear that the surprising, strange-sounding symptom might be a sign of COVID-19, dermatologists at the AAD formed the task force to compile and analyse cases of the condition.
“Most of the evidence is anecdotal, although there is a growing consensus in the medical community that the lesions that are occurring can’t be just a coincidence,” Velimir Petkov, DPM, a doctor of podiatric medicine at Premier Podiatry in Clifton, New Jersey told Everyday Health.
What is the treatment?
“There is no such treatment. To reduce pain or itching, apply hydrocortisone cream to the affected area. However, if this fails to bring relief or symptoms worsen, contact a board-certified dermatologist,” Dr Barua said further.
