The latest odd COVID-19 symptom making headlines: “pernio-like lesions” on the toes that are pinkish-reddish in color and can turn purple over time. The American Academy of Dermatology started a registry of any and all skin-related symptoms associated with the coronavirus, and a member of the academy's COVID-19 task force tells USA Today that she was expecting to see a lot of rashes due to inflammation, but "what was more surprising to me was this overwhelming representation of these ‘COVID toes.'" WKRN reports the phenomenon has also been seen on fingers. Pernio, also called chilblains or perniosis, is a condition that occurs when a person is exposed to the cold and develops skin sores or bumps on their feet. "COVID toes" are not believed to be actual pernio, nor are they believed to be related to cold temperatures.
Rather, experts think they could be caused by inflammation in the tissue of the toes or in the blood vessel wall—or possibly by small blood clots inside the blood vessel. The Washington Post reported over the weekend that researchers suspect the virus is indeed causing blood clots in certain patients, which in some cases leads to strokes even in young, otherwise healthy people. Last week, the Post ran a similar story, noting that some patients are developing clots even after they're put on anticoagulants. "My guess is it’s one of the top three causes of demise and deterioration in COVID-19 patients," one expert says. As for the dermatological symptoms, it's not just COVID toes: Rashes are indeed another possibility. "This could look like bruising underneath the skin or little pinpoint blood spots," says one doctor. "There is some thought this virus ... is causing the obstruction of some of the blood vessels in the skin, which is what’s causing some of those vascular changes." (Read more coronavirus stories.)