PernioAs early as January 2020, a group in Thailand noticed that a patient with Covid-19 developed a skin rash. The findings were very similar to the rash seen in patients infected with Dengue fever. A short time later, Italian doctors reported that about 1 in 5 (20%) of patients with Covid-19 showed some sort of rash.

urticariaIts not surprising that patients with Covid-19 would have skin findings. As the largest organ in the body (and the one that’s easiest to see), the skin often reflects the overall health of the body. Other viral infections—like chicken pox and measles, for example—involve skin rashes.

A wide variety of different skin rashes have been described with Covid-19 so far. These include hives (urticaria), fluid-filled bumps (vesicles)—like chicken pox, pinpoint red dots (petechiae), net-like red and purplish patches (livedo reticularis), and painful red-purple bumps. Dermatologists in France and the United States are now starting shared databases to learn more about these rashes.
exanthem with petechiae
The spots that seem to be most commonly associated with Covid-19 are painful red-purple bumps and spots located on the fingers or toes. These lesions resemble a condition called chilblains (or pernio) that is usually associated with exposure to cold, wet weather. Its not clear why these develop in patients with Covid-19, but they may be an important sign of infection.

If you’ve noticed a new rash or other skin changes that are concerning to you, consider reaching out for a telehealth visit. From the safety of your living room, your doctor should be able to offer helpful guidance.