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The studies conducted so far demonstrate that several patients with “toes COVID-19” are “asymptomatic,” according to the criteria used for the screening of cases.
It all started with a single toe irritated in April, and then both feet were swollen, turned red, purple then blue, and were covered with painful blisters that prevent her from walking or even putting on a shoe. After sending a photo by e-mail to his doctor, the diagnosis came. David had caught the COVID-19, the bottom of the feet.
David, however, is neither a child nor even a ” young “, as in most of the case studies reported on the clinical presentation of the COVID-19. “I am 65 years old, but it may be because I am young in the soul,” he said, jokingly, at the time of telling his troubles with the virus SARS-CoV-2.
After five or six weeks of near-immobility, David was in the process of finding the toes of a size to near-normal, and being able to put shoes for the first time at the end of may. For a few minutes. “The bulbs are parties. All my skin has peeled. Three weeks ago, it would have been impossible to put a shoe. I’m O. K., but just a little concerned at the idea of going for a walk. Let’s say that I’m going to try to make the tour of the block, ” he says.
These symptoms are atypical and non-identified among the “symptoms” official of the COVID-19, David could not have access to a screening test, but it is isolated for fear of spreading the virus and deliver food throughout his convalescence.
“This is really not funny, but because of my age, I’ve come to tell me that it was perhaps the best way to catch the COVID-19 “, he said with irony.
According to Dr. Hélène Veillette, dermatologist at CHU de Québec-Laval University, who advised the national Institute for excellence in health care and social services (INESSS) for the notice published on this subject on the 12th of may last, the number of cases of “toes COVID-19” seen in the offices of dermatologists has increased over the weeks, and it has been “a major issue” in Montreal and Laval.
“We did face many cases of perniose [frostbite] in populations where there were none, and in circumstances not associated with the cold,” she said. These “frostbite” created by the infection to the COVID-19 have been further described in children, ” adds Dr. Veillette, but they can appear in patients of all ages.
If they last two weeks, on average, the symptoms may disappear in a few days in milder cases, supports the dermatologist. Most patients with this form of unusual punishment of the COVID-19, associated with an inflammatory reaction of the blood vessels caused by the virus, usually heal without further treatment by the administration of cortisone. In cases of severe pain, and of plates important, she says, it is necessary to consult a doctor to undergo a biopsy to rule out any other diagnosis.
Laurie Robichaud, an emergency physician at jewish general Hospital of Montreal, recalled having received the emergency in may, a young man with the toes bluish in colour, very painful, which could no longer wear sandals. “We don’t know much yet, except that this without the need for major treatments. I couldn’t even reassure him, to tell him how long it would last, ” she said.
The studies conducted so far demonstrate that several patients with “toes COVID-19” are “asymptomatic,” according to the criteria used for the screening of cases. A small proportion of them also has other mild symptoms, associated officially to infection with SARS-CoV-2, such as the loss of taste, chest pain, or cough. But this condition could be a late event of a previous infection with SARS-CoV-2, passed by unnoticed.
According to the american Association of dermatologists (AAD), this symptom would count for 50 % of the dermatologic manifestations of the COVID-19 reported up here in a global registry, created in the wake of the pandemic. The ADF advocates for the inclusion of this symptom among those who are recognized for the patient to be eligible for a screening test, or an antibody detection test, since people who are infected could be contagious, at least for the first few days of their illness.