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Chilblains or covid?

Chilblains or covid – are they that similar?

Chilblains present as small, itchy red/purple swellings on the skin which can cause cracking ulceration, exposing the skin to risk of infection. The skin can feel like it is burning and may be painful to touch. Covid toe is when patients who have the covid 19 virus present with a similar presentation and treatment.

Where do they occur?

Chilblains typically affect the smaller toes and areas of foot pressure such as a bunion but also occur on fingers, face and ear lobes.

What is a chilblain?

A chilblain (also called pernio) is where a tiny blood vessels under the skin has leaked into the surrounding tissue. The blood vessel constricts under cold conditions reducing the flow of blood to the area. They can hurt.

How do I get them?

You can get chilblains if you have rapid changes in temperature from cold to hot. This can occur though use of hot water bottles, exposure to extreme in temperature such as heaters and open fires, or cold leisure activities like skiing.

Who gets chilblains?

In the UK 10% get chilblains during their life. Chilblains are more prevalent in people with poor circulation and existing health conditions i.e anaemia.

Seasonally in damp, cold winters when temperatures drop to freezing or below, is when people are most at risk especially young children and older adults. Those who are homeless and vulnerable are at risk of this condition as are adults who work outside in cold damp conditions.

Chilblains or covid – what do they look like?

Chilblains are similar to Raynaud’s condition where extremities , in response to cold, become white in colour due to the vessels constricting thin as the vessels dilate the skin becomes red and very painful with numbness and tingling.

Chilblain like symptoms are now being seen in patients with patients who have had Covid 19, but the remarkable aspect is that they are commonly presented in children and young adults.

The symptoms typically appear 12 days after infection from Covid 19 and occur rapidly. For those patients with Long Covid, Covid toe has been seen to last up to 130 days or more. 

Treatments available?

If you have chilblains symptoms:

  • dry skin: creams containing camphor or local anaesthetic such as Balmosa can be used to prevent further symptoms.
  • itchy skin: avoid scratching and use calamine to calm the irritation.
  • broken skin: cover the wound and have it checked by the podiatrist or nurse as soon as possible especially if the patient has Diabetes or Peripheral Vascular Disease.

How do I prevent it?

The best way to prevent chilblains is to keep the extremities warm and dry. This can be achieved by:

  • wearing 2 pairs of thin socks rather than one pair of tic socks.
  • Shoes can be lined with an insole to reflect the cold from the ground and sheepskin can be used to insulate the foot too.
  • Avoid walking on cold floors without shoes or slippers.
  • Regular exercise helps circulation.
  • Stop smoking.
  • Eat a well balanced diet.

Once the feet become cold and symptoms occur, avoid warming them too quickly in front of a heater or open fire, as this will dilate the vessels too quickly and pain will occur as a result.

How long do chilblains last for?

Chilblains last for 7-14 days and any complications such as ulceration or deterioration, can be treated by a podiatrist or nurse.

If you are concerned or worried please contact us, as podiatrists we are able to help.

Covid toes and nails – is it a thing?

Covid toes and nails is becoming increasingly more aware as new information about the disease is emerging. Peripheral neuropathy is now also being discussed as a long covid symptom.

What is covid toe?

Covid toe is a term being noted when patients who have the covid 19 virus present with symptoms in the hands and feet, on toes and nails.

What does covid toe look like?

The symptoms they present with are purplish or red lesions on their toe(s) that are often painful. They could easily be confused with frostbite, chilblains or Raynaud’s disease.

Common lesions patterns include:

  • Morbilliform (measles-like) rash
  • Urticaria
  • Macular erythema
  • Vesicular (blistering, chickenpox-like) eruption
  • Papulosquamous presentation
  • Retiform (net-like) purpura
  • Chilblain-like lesions

Bristow (2020)

What is covid nail?

Unusual nail changes have been noted by a number of covid positive patients, these findings are still coming to our attention.

“a red-violet band or flare developing in her fingernails, just distal to the lunula. This lasted a week and then disappeared.”

College of Podiatry (2020)

Who gets covid toes or nails?

The other remarkable aspect is that they are commonly presented in children and young adults.

Typically symptoms appear 12 days after covid infection and occurs rapidly. For those patients with long covid, covid toe has been seen to last up to 130 days or more. 

The exact cause of these symptoms is still unknown but a vascular rather than thermal aetiology is the current view and will be researched fully in time.

Do you have covid toes or nails.

If you have had or currently have covid19 , please self isolate in accordance to Public Health England guidelines. If you have or suspect you have covid toes or nails please contact your podiatrist or us at Zest Podiatry to gain some valuable advice as to how to manage the symptoms.

There is more information on covid toes and nails at College of Podiatry.

Treatments for covid toe

Currently the same treatments are recommend for all chilblain like lesions. More information can be found at https://zestpodiatry.co.uk/chilblains-or-covid/.

References

College of Podiatry, 2020, COVID toes – now be on the lookout for COVID nails, College of Podiatry, viewed 21/11/2020, <https://cop.org.uk/news-and-features/covid-19/covid-nails>

Bristow, I., 2020, COVID toes, College of Podiatry, viewed 21/11/2020, <https://cop.org.uk/news-and-features/covid-19/covid-toes>

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