Coronavirus symptoms: Pernio is a symptom explained by a dermatologist – what is it?

What was once thought to be a virus which primarily affected the lungs, with the main symptoms of a new and persistent cough, has now been turned on its head. With symptoms ranging from diarrhoea, nausea, conjunctivitis and a loss of smell and taste; it’s difficult to detect how and where this virus might affect one’s body. To add more confusion, there has been mounting evidence which suggests that the elderly and children may have vastly different symptoms than the rest of the population. The deadly virus has also revealed itself through skin conditions, doctors are now learning.


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“COVID toes” have been reported as a well-known skin condition caused by coronavirus.

The condition makes toes look as if they have frostbite.

The American Academy of Dermatology (AAD) has been tracking the dermatological effects that COVID-19 patients are experiencing through a registry where healthcare providers can submit entries.

Why would the toes be affected due to a virus?

Doctors have declared it quite common for people to develop rashes when they’re fighting infections, especially those which infected the respiratory system.

It’s unclear, however, what causes the skin to react to this virus as it has however there could be several reasons including tiny clots in the toes’ blood vessels.

There has also been mounting evidence coronavirus causes abnormalities in blood clotting and this could cause “COVID toes.”

Dr Esther Freeman, director of global dermatology at Massachusetts General Hospital, Harvard Medical School said: “In terms of viruses and their effect on the skin, in dermatology we are used to viruses causing different viral rashes and eruptions.

“It was certainly not out of the ordinary for any of us to think there may be some viral rashes that we would end up seeing with COVID-19, like we see with many other viruses.

“But what has been more surprising is these increasing reports around these pernio-like lesions of the toes.


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“Pernio, a condition where you get red or purple tender bumps on the fingers or toes, also known as chilblains, is usually a reaction to cold temperatures.

“In COVID-19, I prefer to call it “pernio-like rather pernio, since we don’t yet know if  it’s truly the same process.”

Dr Freeman added that some of the other skin findings in the registry include morbilliform eruption, a non-specific viral rash that’s a common skin sign of many viruses and drug reactions; urticaria, also known as hives; and vesicular eruptions, which Dr Freeman describes as “chickenpox-like” blisters on the skin.

What to do if you notice abnormalities on your skin

Dr Freeman advised: “What patients are experiencing are red or purple bumps on their toes or hands, as well as burning sensation, often with pain and tenderness.

“The good news is it seems to go away after about two to three weeks.

“I recommend concerned individuals contact their board-certified dermatologist or their primary care doctor to discuss if they are concerned about the new onset of toe lesions.

“There are other conditions that can cause something similar, so you will want someone to evaluate you and go through a thorough medical history.”

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