Lesions on the Feet with COVID-19
You may have seen some articles in the news over the past few days about lesions on the feet relating to COVID-19.
Please find below very useful information compiled by a learned colleague on dermatological manifestations of Covid-19.
Some of you may have seen this interesting article posted by The General Council of Official Colleges of Podiatrists. I have taken the liberty of translating it, as you may well receive telephone calls/emails from patients asking about these lesions which are manifesting in some children and young adults who are COVID-19 positive:
The General Council of Official Colleges of Podiatrists has today decided to open a registry of possible cases of COVID19 after registering numerous cases of sick people, mainly children and young people, who had small dermatological lesions on their feet.
The COVID-19 is a disease of obligatory information to the sanitary authorities’ reason why the General Council of Colleges of Podiatrists has decided to initiate this registry of possible cases for its correct sanitary treatment and for epidemiological and scientific effects.
Likewise, the Council of Colleges of Podiatrists has established a protocol for the prior diagnosis of these cases for its 7,500 professionals for subsequent treatment and action.
Numerous cases are being observed in different countries: Italy, France, Spain ... It is a curious finding that began yesterday to spread in the healthcare field, among dermatologists and podiatrists, fundamentally: the same symptoms are increasingly being detected in patients with COVID -19, especially children and adolescents, although some cases have also been detected in adults. These are purple-colored lesions (very similar to those of chickenpox, measles or chilblains) that usually appear around the toes and that usually heal without leaving marks on the skin.
Obviously, due to the short time elapsed, scientific evidence cannot be discussed yet. The International Federation of Podiatrists echoed yesterday on its website by publishing this article.
The Council of Podiatrists urges its Colleges and its members to be very vigilant because this may be a sign of detection of COVID-19 that can help prevent infection.
Currently, podiatry clinics and consultations are closed and only those emergencies that have personal protective equipment and minimum safety conditions for patients and their professionals attend to emergencies.
The Council wants to convey a message of reassurance to parents and possible victims, given the benign nature of the lesions, and to remember that they should monitor the appearance of the other clinical symptoms characteristic of COVID-19, such as cough, fever, respiratory distress, etc.
In this sense, the Council of Schools recommends following the following protocol:
• Numerous cases of the presence of erythema in the feet (small redness and inflammation of the skin that, fundamentally, are manifesting in the area of the toes) have been detected in positive patients after performing a PCR. They are similar to chilblains and can appear in isolation (single) or several in the same patient.
• If a patient with these signs is known, in the form of skin rashes, and does not have a previous medical history of trauma, sting or burn, to avoid unfounded alarmism, it is very important to carry out a differential diagnosis to determine if this case, May be compatible with a positive COVID-19 case.
• When these cases are detected by parents or relatives, the child should be kept in quarantine, isolated, and a topical corticosteroid can be applied and temperature control can be carried out, always with the reassurance that these are benign lesions with favorable evolution, but acting with caution being a possible asymptomatic carrier.
• If the case arrives at the podiatric clinic or consultation, it is recommended to make a diagnosis using telemedicine: when the parents detect these signs, they must send one or more photographs to the podiatric clinic.
• It is only recommended to visit the patient in the podiatry consultation if there are safety guarantees for the patient, the family members and the professionals who care for him.
• The clinic must make a record of the case and notify its College to add it to the general record of cases that the General Council has opened.
• To avoid contagion in those affected and their families, it is not recommended to go to primary care centers and hospitals only because of the appearance of these dermatological lesions.
Some images of the detected cases compatible with the COVID-19:
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