Skin symptoms of covid: rash, blisters, what should I do?

Blisters, rash, redness, frostbite … Cutaneous manifestations have been described in cases positive for Covid-19. How are these skin symptoms characterized? Why does the virus cause them? What to do? Answers and advice from Dr. Laurence Le Cleach, MD, a dermatologist.

Blisters, hives, rashes, chilblains… In April 2020, Skin disorders On the face and body of patients infected with SARS-CoV-2 coronavirus. In an April 6 press release, the National Federation of Dermatologists and Venereologists (SNDV) explained: “These are acrosyndromes (pseudo-swelling of the extremities), sudden onset persistent redness Sometimes painful, and transient urticaria“. in May 2022, Covid cases positive for the Omicron variant analyzed by Santé Publique France no longer show any skin symptoms.. However, they do not represent all confirmed cases and the Covid virus has demonstrated its ability to do soIt causes various symptoms According to the people. So we must remain vigilant. What signs on the skin can be associated with COVID-19 infection? When do you consult? the point.

Comparison of the symptoms of Omicron BA1 (present at the end of 2021 in France) with BA4 and BA5 that develop in May 2022 © Public Health France

What are the skin symptoms of Covid disease?

The French Society of Dermatology (SFD) launched a national survey entitled COVIDSKIN on March 30, 2020 for Identification of skin lesions associated with SARS-CoV-2 infection. This call for cases was heard by general practitioners and dermatologists who recorded their observations via a standardized questionnaire. In total, on 492 cases Collected, 311 correspond to cases of anhydrous manifestations (hands and/or feet). The more frequent she was Frostbite (82%). The study says that 49% of people had no symptoms before the lesions appearedWhile nonspecific infectious symptoms and clinical suspicion of COVID (fever, cough, shortness of breath, loss of sense of smell, and advanced age) occurred in 22% and 30% of cases, respectively. “Of the 150 patients tested (121 RT-PCR and 75 sera performed), only 10 were positive (7 RT-PCR and 5 sera with anti-SARS-COV2 IgG)”, revealed Dr. Lawrence Le Klech, a dermatologist at Henri Mondor Hospital and coordinator of the COVIDSKIN study conducted under the auspices of the Social Fund for Development. and Prof. Marie Bello Barry during the Dermatology Days in Paris 2020.

Pimples, hives, swollen fingers: very diverse skin signs

“Different types of skin manifestations are observed. The main ones are: maculopapular rash, by saying that Pimples or red spots spread all over the body, with a predominance of the upper body; Cells resembling nettle stings are formed small papules spread over the body. These two manifestations have been reported in subjects whose infection has been confirmed most often by PCR or serology testing. In general, this occurs within days of the onset of infectious signs of the disease, especially in patients aged 40 to 50 years., says Dr. Lou Klitsch. On the contrary, Swollen fingers tend to occur in young adultsThey are teenagers, young adults and even children. In these patients, Most of the time, PCR and serology tests are negative. Right now there is a debate going on about trying to determine if these frostbites are simply caused by patients being inactive and possibly barefoot all day during confinement or if they actually contracted Covid-19. The last case did not show symptoms of illness (fever, cough, fatigue and difficulty breathing) and the result of the PCR and serology test was negative,” specify. hypothesis a specific immune reaction To explain this absence of symptoms put up.

← At the start of the Covid-19 epidemic, an unprecedented frequency of Swollen fingers consultations It was mentioned in Italy Then in France. In order to assess their links to infection with the SARS-CoV-2 virus, a team of researchers began a study to study all people who received a Covid cell at Nice University Hospital between April 9 and 17 who had this type of lesion. . During this period, 40 patients with frostbite were examined. None of them presented a serious form of Covid-19 and most of them were young adults (average age 22 years). If they all had contact or suspected SARS-CoV-2 in the three weeks preceding the consultation, the nasopharyngeal virus scan (PCR) result was negative for all of these patients, and positive sera were found in one third of them. Just. “If a causal relationship between skin lesions and SARS-CoV-2 is not established by this study, it is nonetheless highly suspected, in particular because The number of patients suffering from frostbite at this time of year in our area is especially surprising. In addition, we observed clusters of cases: several people simultaneously suffer from frostbite in a few siblings or families. hung Professor Thierry Bassiron* who directed this work. For researchers, frostbite may be the result of a Especially effective innate immunity. “This damage is not It is not serious and retracts without consequences Over the course of a few days to a few weeksProfessor Basiron said. They caught an infectious episode with SARS-CoV-2 which in most cases has already ended. Patients infected with the virus recover effectively and quickly after infection.

What do you do when in doubt?

In general, consulting your GP or dermatologist when you have skin manifestations is a good idea anyway. “If these skin attacks Accompanied by accompanying signs such as feverDifficulty breathing and coughing (or headache, fatigue, colds, editor’s note as frequent signs of Omicron, Editor’s note), it is actually worth at least one consultation to show the skin lesions to his doctor who can then tell us what to do.” The dermatologist explains. It’s always possible Get tested in pharmacies for CovidOver-the-counter, with antigen test or in vitro (PCR test, most effective). Monday Free for fully vaccinated people against covid.

Wearing a mask aggravates skin problems

The skin surrounded by the mask undergoes frequent friction and bathes in a hot and humid environment. However, the face is not used to being completely covered, which can lead to thisThe appearance of pimples or the enlargement of some skin diseases Already present (eg acne). “Wearing a mask will tend to exacerbation of facial skin diseases, Any skin diseases that affect the face in particular, such as Acne, seborrheic dermatitis or rosacea. A little intensive care will help reduce these inconveniences, Dr. Lou Klitsch says: To improve the condition of your skin and reduce the appearance of pimples, it is necessaryGentle skin cleansing in the morning and evening but also Moisten it well to help it deal better with friction. Also pay attention to Don’t wear too much makeup That will only increase the blockage of the skin.

Thanks to Dr Laurence Le Cleach, dermatologist at Henri Mondor Hospital and coordinator of the COVIDSKIN study conducted under the auspices of the SFD (French Society of Dermatology).

Sources:

COVID-19: Frostbite, collateral damage to active immunity. Inserm. January 11, 2021

French Society of Dermatology (SFD) Press Release, April 8, 2020

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