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Nurses should look out for ‘COVID toe’ in patients

COVID-19 symptom can look like chilblains, nurse consultant says 
A picture of COVID toe, which has chilblain-like presentation

COVID-19 symptom can look like chilblains, nurse consultant says

This article was updated on 29 January 2021 to include latest information

A website is helping healthcare professionals and the public recognise whether a rash could be a sign of COVID-19.

The covidskinsigns site carries more than 400 images of rashes collected via the COVID Symptom Study app , which was set up during the first wave of the pandemic to gather information from the public about the signs and symptoms of virus.

The emergence of skin rash as a sign of COVID-19

According to the British Association of Dermatologists , which developed the website, the most common skin rashes are urticaria (a hive-like rash), a ‘prickly heat’ or chickenpox-type rash, and redness that looks like chilblains

COVID-19 symptom can look like chilblains, nurse consultant says 

A picture of COVID toe, which has chilblain-like presentation
Picture: Mid Yorkshire Hospitals NHS Trust

This article was updated on 29 January 2021 to include latest information

A website is helping healthcare professionals and the public recognise whether a rash could be a sign of COVID-19.

The covidskinsigns site carries more than 400 images of rashes collected via the COVID Symptom Study app, which was set up during the first wave of the pandemic to gather information from the public about the signs and symptoms of virus.

The emergence of skin rash as a sign of COVID-19

According to the British Association of Dermatologists, which developed the website, the most common skin rashes are urticaria (a hive-like rash), a ‘prickly heat’ or chickenpox-type rash, and redness that looks like chilblains on the fingers or toes.

Rash was added as a sign to the app, which has been downloaded by 4 million people in the UK – reports emerged last spring of rashes in patients admitted to hospital with COVID-19.

App users were invited to submit images of their rash to the COVID Symptom Study website, with almost 3,200 images uploaded. A team of dermatologists then reviewed the images, classifying them according to clinical type and selecting the final images for the website.

In August 2020, Mid Yorkshire Hospitals NHS Trust vascular nurse consultant Leanne Atkin warned discoloured toes could be a sign of COVID-19.

She spoke out following a rise in the number of patients presenting to vascular clinics with signs that could be attributable to arterial disease.

However, Dr Atkin said these patients often go on to test positive for COVID-19.

Swelling and redness at the ends of toes

Dubbed ‘COVID toe’, the condition can have a similar appearance to chilblains, which commonly cause swelling and redness at the ends of toes and fingers, and was first identified as a sign of COVID-19 by podiatrists in Spain in April 2020.

Affected patients may also experience burning sensations or itching, with pain or tenderness around the affected toe. 

Awareness of ‘COVID toe’ among healthcare staff

‘It’s imperative that there is an increased awareness among practitioners and clinicians of patients’ feet, and how changes in colour could be a sign of infection, even in the absence of any other symptoms,’ said Dr Atkin.

View our COVID-19 resource centre


Further information

This article was first published on 4 August 2020

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