We’ve all learned the primary signs of COVID-19: a dry cough, fever and trouble breathing. We’re all monitoring ourselves and loved ones, other symptoms can include nausea, delirium, loss of taste or smell and diarrhea. We’re learning more about it every day. Doctors were surprised when they started recognizing heart problems as a sign of the virus. And, as time goes on, doctors are seeing rashes associated with the illness.

It started with doctors recognizing “COVID toes.” It is a rash that younger people with COVID-19 got who were otherwise asymptomatic. More and more rashes were seen on people with COVID-19, confusing doctors, and underscoring the fact that we have so much to learn about the virus.

“People are breaking out in hives, red blotches all over their body and even developing rashes that look like chickenpox,” said Dr. Raman Madan, a dermatologist at Northwell Health Huntington Hospital on Long Island.

It’s also unclear as to whether or not the rashes are symptoms or the result of other problems. Are the other symptoms causing the rashes — like the inflammation? Or, are the rashes directly caused by the virus — like in the case of chickenpox. They may be a “reaction pattern” instead of a primary symptom. They worry that the rashes may, in fact, be “co-infections” meaning that COVID-19 makes people more vulnerable to secondary infections.

Doctors just aren’t sure why people are getting these rashes. “One hypothesis is there’s just a lot of inflammation caused by the virus,” said Dr. Esther Freeman, a dermatologist at Massachusetts General Hospital. However, she hastened to add that that was just a theory.

Twenty percent of COVID-19 patients in a study in Italy had rashes, hives or lesions. “Patients may present with skin lesions on their feet or toes or red rashes that may resemble a skin infection at first glance,” said Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital. “Many of these rashes may represent superficial clotting or even bleeding in the skin or extremities.”

Many rashes have been associated with COVID-19. There are blisters that look like chickenpox. One rash looks like a lace or fishnet pattern on the skin. Another looks like measles. A fourth rash looks like hives. And “COVID toes” looks like frostbite.

So many different medical organizations are researching COVID-19. The American Academy of Dermatology is studying the rashes to find out how significant they are to COVID-19 patients, how best to treat them and what their connection to the virus is.

While we are waiting to learn more, you can still keep an eye out for them. It’s good to let your doctor know if you have a rash. Even when there isn’t a pandemic altering your primary health professional to changes in your skin can help keep you healthy.

Banner Image: These small, flat and raised red bumps accounted for 47 percent of rash cases in COVID-19 cases. Image source: COVID-PIEL Study via BBC