Health Pseudo-frostbite, hand and foot irritation, new symptoms of Covid-19?

Pseudo-frostbite, hand and foot irritation, new symptoms of Covid-19?

Swollen rash-like skin lesions on the back of the hands and feet could be a symptom of Covid-19, as seen here on the lesions observed by Dr. Oliverès-Ghouti on one of his patients. – C. Oliverès-Ghouti

  • Skin lesions on the hands and feet may be a new symptom of Covid-19.
  • The National Union of Dermatologists-Venereologists reports this type of lesion in patients with little or no symptoms.
  • They call for vigilance, while these patients who suffer from mild forms of the disease could however be contagious.

We knew, since the onset of the disease, the symptoms close to the flu. Body aches, fever, dry cough, migraines and, in the most severe cases, respiratory distress and pneumonia typical of the coronavirus. More unexpected and surprising, it was discovered two weeks ago that coronavirus caused in a certain number of patients the
loss of taste and smell.

Little by little, doctors are learning more about Covid-19 every day, and this week the National Union of Dermatologists and Venereologists (SNDV) is alerting to cutaneous manifestations of coronavirus, which may resemble hives.

Specific skin lesions

“A WhatsApp group of more than 400 dermatologists (liberal and hospital-university), organized by the SNDV, has highlighted skin lesions, associated or not with signs of Covid,” indicates this college of dermatologists. These are acrosyndromes (appearance of pseudo-frostbite of the extremities), sudden onset of persistent, sometimes painful redness, and transient hives lesions. “

“In this WhatsApp group created three weeks ago, cases of urticaria and varicella-type rash have been reported in patients who had already had it,” explains to 20 minutes Dr. Catherine Oliverès-Ghouti, dermatologist, member of SNDV and of the famous WhatsApp group. The skin lesions observed are pseudo-frostbite: “pseudo” because it looks like
frostbite, but not caused by exposure of the skin to a damp cold. This manifests itself in slightly swollen redness on the backs of the hands, fingers and toes, describes the dermatologist. And unlike classic eczema or irritation due to repeated use of hydroalcoholic gel, these lesions do not scratch, do not burn, but are a little painful. It has appeared in patients of all ages, with no medical history, and even in children. “

Especially no corticosteroid creams

Quickly, a common point emerges: “these patients had the distinction of having cases of Covid-19 in their immediate entourage, says Dr. Oliverès-Ghouti. This is the case of two young children who had these skin symptoms and whose father, on the other hand, presented the classic symptoms of the disease. This is why these signs are thought to appear for mild forms of the coronavirus. Since Covid-19 can attack the pulmonary blood vessels, it is now believed that it can also attack the skin blood vessels, which would explain these specific lesions. ” And to relieve these lesions, “above all, do not self-medicate with corticosteroid creams, which would make things worse, warns Dr. Oliverès-Ghouti. You can possibly relieve the skin with oily restorative creams. ”

To date, these signs would therefore be observed in patients with little or no classic symptoms of Covid-19. Thus, “this skin involvement has not been observed in severe cases requiring hospitalization, confirms to 20 minutes Pr Martine Bagot, head of the dermatology department of
Saint-Louis Hospital in Paris. And what challenged the profession is this similar picture of hand / foot involvement in very young patients. At the moment, these patients are not being screened, an approach reserved for the most serious cases, but large-scale serological tests will allow us to learn more about this new symptom. But already, here in Saint-Louis, we are fortunate to have been able to screen patients with these skin symptoms and an article is being written on these cases proven by samples. This will allow doctors to find out more about this Covid-19. “

Skin symptoms still relatively little observed

As for general practitioners, these possible cutaneous manifestations of Covid-19 have still been little observed. “I have not seen this type of symptom in any Covid-19 patient I have examined,” 20 minutes Dr. Jean-Louis Bensoussan, general practitioner member of MG France. In addition to the well-known ENT symptoms and fever, there are many Covid-19 patients who also have digestive problems and loss of taste and smell. “

Same observation for Dr Luc Duquesnel, general practitioner in Mayenne and president of the Federation of doctors of France: “I saw passing these observations of the SNDV, but to date, I did not note these cutaneous symptoms nor in consultation with cabinet, nor on call regulation in the department, he said to 20 minutes. However, I have seen and had hundreds of patients on the phone in the past few weeks. ” Like his colleague, this general practitioner noted “loss of taste and smell, as well as diarrhea, as very frequent signs of coronavirus in patients”. But Covid-19 also indirectly causes skin damage. “I frequently see skin syndromes in the hands, but which are linked to excessive use of hydroalcoholic gel and the use of gloves,” notes Dr. Duquesnel. It can cause irritation. ”

Increased vigilance

However, Dr. Duquesnel takes the alert given by his dermatologist colleagues very seriously. “What they found is very interesting. Now that they’ve brought this likely sign to light, it’s going to be the subject of heightened vigilance. ” Thus, this discovery “allows us to say:” beware, asymptomatic patients with this type of skin lesion may be carrying Covid-19, therefore
contagious “”, confirms Professor Bagot.

He continues: “And in this case, you must avoid coming into contact with fragile people. When large-scale serological tests are possible, we will see if these patients with only these skin signs have developed antibodies to the coronavirus, which would prove that they have contracted it. “



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