Some COVID-19 patients had persistent skin-related symptoms long after their initial infection has cleared, according to a new analysis.

‘Study findings reveal a previously unreported subset of patients with long-standing skin symptoms from COVID-19, in particular those with COVID toes.’

For the analysis, researchers established an international registry for COVID-19 skin manifestations in April 2020, in collaboration with the International League of Dermatological Societies and the American Academy of Dermatology. 




Clinicians were contacted in June and August to update COVID-19 laboratory test results and the duration of patients' COVID-19 skin symptoms. The team defined long haulers as anyone with skin symptoms of COVID-19 that persisted for at least 60 days.
The team evaluated almost 1,000 cases of patients with skin manifestations of COVID-19. Among 224 total suspected cases and 90 laboratory-confirmed cases of COVID-19 from 39 countries with information on symptom duration, the median duration of symptoms was 12 days. Rash-like morbilliform and urticarial eruptions lasted a median of seven days and four days, respectively, for patients with lab-confirmed COVID-19, with a maximum duration of 28 days.
Papulosquamous eruptions, which are scaly papules and plaques, lasted a median of 20 days in lab-confirmed cases, with one confirmed long hauler eruption lasting 70 days. Pernio/chilblains, or redness and swelling of the feet and hands, commonly known as "COVID toes," lasted a median of 15 days in patients with suspected COVID-19 and 10 days in lab-confirmed cases.
Notably, six patients with pernio/chilblains were long haulers with toe symptoms lasting at least 60 days, with two lab-confirmed patients with COVID toes lasting longer than 130 days.
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"We encourage clinicians taking care of patients with COVID-19 to ask about and evaluate any skin symptoms. Health care providers can enter information into our registry to further our understanding of the dermatologic effects of COVID-19."