Covid-19: new skin symptoms? Dermatologists alert and investigate

The national union of dermatologists has highlighted skin lesions associated with cases of Covid-19. Further studies have yet to establish a proven link.

Cough, fever, loss of smell … and now frostbite or hives? The list of symptoms associated with Covid-19 may continue to grow. The National Union of Dermatologists and Venereologists (Sndv) warns of skin lesions observed in some people affected by the new coronavirus.

A group of more than 400 dermatologists (liberal and hospital-university) organized themselves to discuss these clinical cases, whether or not associated with Covid signs. “We observe several types of dermatological pathologies, explains to doctor Marc Perrussel, vice-president of the Sndv and dermatologist at the CHU de Pontchaillou in Rennes. These are mostly pseudo-frostbite on the extremities. ”

The patients with these symptoms that he examined – “a number for three weeks, just three this morning (Thursday, April 9, 2020, note)” – frostbite on the hands or feet, persistent redness sometimes painful, sometimes bluish and / or ulcerated.

Essential screenings

Other patients have eczema, erythema on the face or hives. Samples taken at Antony hospital (Hauts-de-Seine) from 20 suspected cases with these symptoms revealed that 12 of them had Covid-19.

Important note: these skin signs are mainly associated with non-serious forms of Covid. “We don’t see these signs in people hospitalized in intensive care, for example,” adds Dr. Perrussel. And they often appear in young people. ”

According to the vice-president of the dermatologists’ union, it is essential to screen all these patients because “this is a potentially contaminating population”.

A call for the identification of cases

In this context, the French Society of Dermatology (SFD) for its part launched a call for the inventory and precise documentation of the cases observed in France.

“The number of cases of frostbite seems significant and the occurrence is unusual in this season,” the institution said in a statement published Wednesday, April 8, adding that very few of these observations were supported by results of Covid tests. Most of them occur in patients without associated signs ”.

All dermatologists are invited to report suspected cases they may encounter, documenting them with context, photographs and possibly biopsies.

Vigilance and prudence

Faced with insufficient evidence gathered for the moment, the SFD calls for vigilance but also for caution:

Among the rare documented cases, it seems that they occur rather late in the infection, which could thus suggest a mechanism of immunological origin. To date, we do not yet have evidence to confirm that this is an early sign of Covid-19 which should lead to strongly suspect the diagnosis and lead to isolation of the patient.

What do the health authorities say? Asked on this subject, the Director General of Health Jérôme Salomon replied on Wednesday April 8, during his daily press briefing, that “to date, we do not yet have evidence to affirm that these lesions are a skin sign Covid-19 ″. Before nuancing: “you know, we learn every day about this virus and this disease”.

Several studies in progress

These new observations therefore merit further investigation. “Eminent professors at the Saint-Louis hospital in Paris are currently carrying out tests and taking samples and will publish a scientific publication on this subject in the coming weeks,” said Dr Perrussel.

The SFD also ensures that it will investigate to “confirm or not this association or possible link”. And could set up channels to “allow dermatologists and generalists who see these patients on the front line, to refer them to referral hospitals to take samples in order to test them”.

Ultimately: be careful if you notice this kind of symptoms on yourself, because as Professor Marie Beylot-Barry, president of the French Dermatology Society points out:

Any frostbite is not necessarily a sign of Covid, frostbite is still quite common dermatosis.

But in any case, the appearance of these symptoms should prompt you to consult a dermatologist, “we continue to exercise during confinement, mainly in teleconsultation,” insists the vice-president of the national union of dermatologists.

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