The Day

Toes emerge as a new site for symptoms.

- By LAURAN NEERGAARD AP Medical Writer

Skin doctors suddenly are looking at a lot of toes — whether by emailed picture or video visit — as concern grows that for some people, a sign of COVID-19 may pop up in an unusual spot.

Boston dermatolog­ist Esther Freeman expected to see skin complaints as the pandemic unfolded — various kinds of rashes occur when people get very ill from other viruses.

“But I was not anticipati­ng those would be toes,” said Freeman of Massachuse­tts General Hospital, who has viewed via telemedici­ne more toes in the last several weeks than in her entire career.

They’re being called “COVID toes,” red, sore and sometimes itchy swellings on toes that look like chilblains, something doctors normally see on the feet and hands of people who’ve spent a long time outdoors in the cold.

Don’t race to the emergency room if toes are the only worry, said the American Academy of Dermatolog­y.

Earlier this month, it issued advice that a telemedici­ne check is the first step for people wondering if they have “COVID toes” and who have no other reason for urgent care. Doctors then should decide if the patient should stay in home isolation or get tested.

The most common coronaviru­s symptoms are fever, a dry cough and shortness of breath — and some people are contagious despite never experienci­ng symptoms. But as this virus continues to spread, less common symptoms are being reported including loss of smell, vomiting and diarrhea, and increasing­ly, a variety of skin problems.

In one report, dermatolog­ists evaluated 88 COVID-19 patients in an Italian hospital and found 1 in 5 had some sort of skin symptom, mostly red rashes over the trunk.

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