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The skin condition known as Covid toe may be a side effect of the immune system’s response to fighting the virus, study finds.
The symptom is frostbite-like inflammation and redness on the hands and feet, with the condition sometimes lasting for months. It usually develops within a week to four weeks after infection and can lead to swelling or color change in the toes and fingers.
The researchers behind the study, which was published in the British Journal of Dermatology, looked at 50 participants with the disease and 13 with similar frostbite that occurred before the pandemic.
They found that a mechanism behind both types of disease involved the body generating an immune response with high levels of certain autoantibodies, which mistakenly target and react with a person’s own cells and tissues as well as with the invading virus. They also found an overlap with type I interferon, a key protein in the antiviral response.
In addition to the immune system, cells lining the blood vessels that supply the affected areas also appeared to play a vital role in the development of Covid toes and frostbite.
Lead author of the study, Dr Charles Cassius, said the research has led to better understanding of the disease. “The epidemiology and clinical features of frostbite-like lesions have been extensively studied and published. However, little is known about the pathophysiology involved. Our study provides new insights.
Concerns were expressed in the early months of the pandemic that the so-called Covid toe was one of the unrecognized symptoms of infection, after patients in several countries reported the disease although in some cases , they did not exhibit any of the usual symptoms.
Red or purple lesions on the side or sole of the foot or on the hands and fingers have been described. In May 2020, the European Journal of Pediatric Dermatology reported an “epidemic” of cases in children and adolescents in Italy. He said that unlike other rashes associated with the coronavirus, it had not been seen before.
“We have observed an ‘epidemic’ of acute, self-healing vascular lesions of the hands and feet in asymptomatic children and adolescents. These lesions were a novelty which led us to establish a link with the other much more severe novelty, namely the Covid-19, which also occurred almost simultaneously, ”they wrote.
British podiatrist Dr Ivan Bristow agreed that for most people the disease cleared up on its own – similar to frostbite. However, he said some people might need treatment with creams and other drugs. “Confirmation of the cause will help develop new treatments to manage it more effectively.”
Dr Véronique Bataille, consulting dermatologist and spokesperson for the British Skin Foundation, said the Covid toe was seen very frequently during the first phase of the pandemic, but had been less common in the current wave of variant Delta.
She said it could be because more people are being vaccinated or have some protection against Covid from past infections. “Presentations after vaccination are much rarer.
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