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COVID-19 Rashes

COVID-19 Rashes

COVID-19 is an infection caused by the SARS-CoV-2 virus which has spread globally resulting in a pandemic.  It may affect people of all ages, but the most severe symptoms typically occur in the elderly or those with underlying health conditions.  The infection is most commonly associated with fever, cough, shortness of breath, fatigue, and loss of taste and smell.

However, a small percentage of those infected with COVID-19 may also develop skin rashes and lesions.  In some people, these skin conditions may be the only sign of a COVID-19 infection.  While this is an evolving area, there are at least 5 different categories of COVID-19 related rashes and skin conditions.

If you experience any of these , it is best to seek the medical attention of a board certified dermatologist like those at Iowa Dermatology Consultants.

Pseudo-Chilblains “COVID Toes”

One of the most commonly reported rashes associated with COVID-19 is “COVID Toes”. It typically occurs in healthy children, teens, and young adults. These people may have very mild symptoms or sometimes no preceding symptoms of COVID-19. The rash seems to have a delayed onset after COVID-19 infection and appears as red spots that become dusky or purple and appear in acral areas such as toes and/or fingers. There may be a burning or itching sensation with swelling or discomfort. Sometimes these areas develop blisters.

Dermatologists call this rash “pseudo-chilblains” because it very closely resembles a condition called chilblains that occurs on fingers and toes in cold, damp weather. However, pseudo-chilblains is not associated with cold exposure or other related risk factors. When this occurs due to a COVID-19 infection, it may last several weeks and then resolve. There have been some reports of it lasting several months. The prognosis with COVID-19 related pseudo-chilblains is excellent, with an overall survival rate of 99%.

Macular Papular Rash

Red widespread bumps predominantly on the trunk are the second most common rash associated with a COVID-19 infection. This typically occurs at the onset of COVID-19 symptoms or shortly after. It is slightly more common in women, and is typically itchy.

There have been several variants of this described in the medical literature. Some of these cases look like pityriasis rosea (a common self-limited rash in young adults) with oval red raised bumps that occur on the trunk and align with the skin lines in a “Christmas tree pattern.” This is more common in adults and may last a few weeks before resolving. Prognosis is excellent, with an overall survival rate of 98.2%.

Urticaria (Hives)

Urticaria also known as hives in the 3rd most common rash reported with a COVID-19 infection. This rash has red, swollen welts that are transient and migrate over the body. Onset is typically at the same time as the COVID-19 infection or shortly after. It may last several days to weeks. More than half of the cases occur in middle-aged women.

Hives have been reported in association with multiple different viral and bacterial infections, and thus, they are not specific to COVID-19. However, when seen in association with this infection, the survival rate is about 97.5%.

Vesicular (Blistering) Rash

COVID-19 may also cause a widespread red, blistering rash. Dermatologists call this a vesicular rash, and it may look very similar to chicken pox with multiple tiny blisters on a red base. This most commonly affects the trunk and occurs at the onset of COVID-19 symptoms or shortly after. This rash has typically been reported in adults. Reported survival with this rash is 96%

Vaso-Occlusive Lesions

These skin findings are the least commonly reported in COVID-19 infection. Lesions appear as fixed purple, lacy or net-like spots on the skin. Sometimes the skin looks mottled and there are star-shaped areas that usually occur on the extremities, indicating decreased blood flow or small clots in the blood vessels.

Unlike pseudo-chilblains, this occurs mostly in elderly adults with more severe COVID-19 symptoms, such as pneumonia which may require hospitalization. These skin lesions may occur at the onset of severe COVID-19 symptoms or several days after. Vaso-occlusive skin lesions are associated with the lowest survival rate of 78.9%.

Why Iowa Dermatology Consultants?

Iowa Dermatology Consultants believes in a patient focused approach to care.  They work with patients forming an active partnership in treatment to help repair the physical and emotional damage of skin disease.

At Iowa Dermatology Consultants, all of our physicians are board certified dermatologists. Your care provided by Dr. Snider, Dr. Smith,  or Dr. Myers is founded in knowledge and experience which exceeds that of the typical general practice physician.  Together they have almost 50 years of combined experience in diagnosing and treating a vast array of skin conditions.  This includes over 16,000 hours of patient care training to ensure that a board certified dermatologist can expertly diagnosis and treat over 3000 dermatologic conditions.