How does covid-19 affect the skin?

How does covid-19 affect the skin?Unexpected chilblains, unusual rashes, and flareups of existing conditions-Katharine Lang asks experts how the skin can react to covid infection Katharine Lang freelance journalist "Covid toes"-swollen and itchy red or purple toes, or "pseudo chilblains"-were initially reported in a Spanish study published in May 2020. 1 They make up one the of the five groups of skin conditions the study authors identified, the others being urticarial legions, maculopapular eruptions, other vesicular eruptions or rashes with small blisters, and livedo or necrosis.Many skin conditions have since been observed in patients with covid.They range from those that are common and not specific to the virus-such as maculopapular rash, hives, covid toes, or urticaria-to livedo reticularis, a condition more commonly seen in people with severe or critical illness, that has, rarely, been observed as the first symptom of covid infection. 2 Covid toes and other inflammatory rashes are reported more often in patients with mild or otherwise asymptomatic infection, says Tanya Evans, medical director of the skin cancer programme at the melanoma clinic at Memorial Care Saddleback Medical Center in California in the US.Livedoid or retiform purpura, acral ischaemia, and purpuric lesions are more often seen in patients who are critically ill with covid and are associated with systemic coagulopathy and worse prognosis, Evans adds.