Scientists think they know why some people who contract Covid develop chilblain-like lesions on their toes and sometimes fingers. It appears that the condition is a side effect of the body shifting into attack to fight against the virus.
Researchers have narrowed down the parts of the immune system that they believe are involved, publishing their findings in the British Journal of Dermatology. This breakthrough could help with treating people and easing their symptoms.
What are Covid toes?
It is possible for people of any age to get Covid toe, but it is most common in children and teenagers.
The skin around the toes is usually affected, but it can sometimes affect the fingers as well, making them look a red or purple colour. Symptoms can vary between people, with some finding it pain free, while others develop painful raised bumps. Some find the rash extremely itchy and sore, and blisters and swelling can occur, as well as areas of rough skin, and sometimes pus.
One 13 year old from Scotland encountered serious difficulty when she developed Covid toe earlier this year. She could barely walk or wear shoes, and had to rely on a wheelchair for long walks.
Those with the condition often don’t have any of the classic symptoms of Covid, such as fever, persistent cough and loss of taste or smell. the length of time it lasts can vary too, with some having it for only weeks, while for others it lasts for months.
Why does it happen?
The recent study from the University of Paris is based on skin and blood tests. It involved 50 people with suspected Covid toe in spring 2020, and 13 people with similar lesions occurring before the start of the pandemic.
The latest findings suggest that two parts of the immune system are involved. Both of these are mechanisms used by the body to fight off coronavirus. One is an antibody that attacks people’s own tissues and cells as well as the invading virus. The other is an antiviral protein, type 1 interferon. It also involves cells that line small blood vessels that supply the affected areas.
The researchers hope that their findings will help medics and patients gain a better understanding of the condition.
How is it treated?
Dr Ivan Bristow, a podiatrist in the UK, says the lesions typically go away on their own for most people. It is just like the normal chilblains generally seen during cold temperatures and in those with circulation problems. However, some can need treating with drugs and creams. He believes that now the cause is confirmed, it “will help to develop new treatments to manage it more effectively”.
Meanwhile, dermatologist and spokesperson for the British Skin Foundation, Dr Veronique Bataille, says Covid toe is not as big a problem as it was. During the early stages of the coronavirus pandemic, the condition frequently occurred. But since the wave of the Delta variant began, it is less commonly seen. Dr Bataille thinks this is a result of more people having a vaccination or some form of protection against Covid due to previous infection. It is “much rarer” for people to present the condition after vaccination.
However, she acknowledges that the links between skin conditions and the virus are not always made. This is because skin problems relating to Covid may appear some time after the acute infection or in those who suffer from no other symptoms. But the British Skin Foundation have compiled a list of conditions with possible links to Covid.
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