Skin rashes are the ONLY symptom for 1 in 5 Covid patients, docs warnMarch 17, 2021
SKIN rashes are the only symptom of Covid in one in five people infected, doctors say.
Patients have suffered itchy welts or eczema all over their body, or mouth ulcers and “Covid toes”.
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The NHS only lists a persistent cough, high temperature and loss of taste and smell as symptoms of the coronavirus that require a test.
However, doctors have been urging for the list to be expanded to include signs, such as a rash, for several months.
The ZOE symptom tracker app, used by millions of people in the UK, has collected statistics on how many people are affected.
The data, analysed by a team at King's College London (KCL), was published in the British Journal of Dermatology.
The paper said: “Strikingly, among the respondents of the independent online survey, we found that 17 per cent of SARS‐CoV‐2‐positive cases reported skin rashes as the first presentation, and 21 per cent as the only clinical sign of Covid‐19.”
Researchers warned cases of Covid would be missed if using the NHS criteria for testing alone.
Although rashes were no more common than a fever, they “last longer” and could even require emergency medical treatment.
Covid is predominantly a respiratory disease, but scientists say it affects all kinds of systems in the body, from blood vessels to the heart.
Dr Emma Wedgeworth, Consultant Dermatologist and British Skin Foundation spokesperson, told MailOnline: “We have become increasingly aware that skin rashes can be a sign of Covid-19 and indeed in some patients, the only sign. Rashes associated with covid can vary significantly.
“Doctors and the general public should be alert to the fact that unusual changes in the skin may be a manifestation of Covid-19.”
An online library of 400 photos, categorised by the British Association of Dermatologists, can help people spot the signs.
So what are the differences between the rashes?
Photos on the database show chilblain like lesions on the toes and fingers of people with Covid.
Dermatologists said the skin complaint was “relatively rare” before the pandemic, suggesting it is definitely as a result of Covid.
They said: “At the start of the pandemic, dermatologists noticed this type of rash much more frequently and in warm weather which was very unusual.
“Eventually the link with Covid was made.”
This rash seems to be more common in younger people and appears later in the infection – sometimes several weeks later.
The rash appears as reddish and purplish bumps on the fingers or toes and can affect many digits, and although it is sore it doesn’t tend to be itchy.
A variety of problems in the mouth and on the lips have been reported by coronavirus patients.
Dermatologists said: “Lips may feel sore and can become dry and scaly as they recover. Soreness inside the mouth can also occur.”
Photos showed the blistered and swollen lips of patients, almost as though they had suffered an allergic reaction.
KCL has previously reported of “Covid tongue” – when the tongue changes during coronavirus infection by swelling or developing an abnormal colour or texture.
This is a common pattern seen in viral infections, dermatologists say, accompanied by symptoms of a viral illness – like Covid.
But sometimes patients have the shockingly bright rash without any other signs of disease.
The widespread rash causes numerous reddish blotches or bumps over the body.
Viral exanthems also show when people have measles or chickenpox, for example.
Eczema on the neck and chest
Eczema is an itchy condition which can cause the skin to crack and sometimes get infected.
People with Covid have been developing eczema on their neck and chest area.
Experts said: “It is usually quite pink and is very itchy. It can appear at any time during or after the infection and usually lasts a long time.”
Experts say this rash is most easily recognisable because it shows as deep red spots that look like bruises.
The medical name for the condition is “purpuric rash”.
“The spots or patches are caused by damage in the superficial tiny blood vessels with bleeding into the skin”, dermatologists wrote.
Photos show the spots varying in sizes in multiple parts of the body – in one case appearing in the corner of someone’s eye and in another across both feet.
One of the rashes seen in a range of photos is a “papular and vesicular” rash.
It resembles prickly heat, with small red, raised bumps across the skin that are very itchy.
The condition can spread anywhere on the body, but typically likes the elbows, knees and backs of the hands and feet.
It can persist “for weeks”, dermatologists said, well past the initial infection period.
Hives, also known as urticaria, appear early on the infection, experts say, but last beyond the contagious period.
“The rash appears as sudden raised hives or wheals on the skin which come and go quite quickly over hours and are usually intensely itchy. It can involve any part of the body.
“If it affects the face, it can cause swelling of the lips and eyelids.
“The eruption can also start with intense itching of the palms or soles.”
The rash is usually treated with antihistamines, and if the patient has lip swelling it is important to check that there is no difficulty in breathing because this would be a medical emergency.
This condition typically affects young people, with images showing the rash covering various parts of the body, including the stomach, armpit and breasts.
Usually this rash is seasonal in nature, typically occurring in autumn and winter, dermatologists said.
“It is thought to be viral in origin, although never proven.
“It can last several months before clearing.”
The rash starts with a single red scaly area known as a “herald patch”, followed a few days later by multiple smaller patches.
The NHS says the rash may continue to spread for up to six weeks.
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