If You Have This on Your Skin, You Could Have Severe COVID, Study Shows

100 percent of study subjects with this symptom ended up in the hospital.

By now, we're all familiar with the most common COVID symptoms: we know that fever, cough, and loss of smell or taste—and especially a combination of these—could easily spell trouble. But there's one symptom that's rarely talked about, yet associated with some of the worst COVID cases. A new analysis of patients with long-COVID—those who experience prolonged coronavirus symptoms for 60 days or longer—reveals that one dermatological symptom almost universally ends in a hospital visit. That symptom is called retiform purpura, a necrotic rash resulting from compromised blood vessels.

If this sounds a bit frightening, it's because it most definitely is. The analysis, conducted by the European Academy of Dermatology and Venereology (EADV), explains that out of the 990 cases analyzed for the study, every patient that presented with retiform purpura was hospitalized. COVID patients with this symptom have in many cases suffered vascular damage, indicating that the virus has deeply infiltrated the organs. A net-like pattern appears under the skin as the blockage of blood flow worsens.

According to Esther Freeman, MD, director of Global Health Dermatology at Massachusetts General Hospital, these types of dermatological symptoms can offer much needed clues about a patient's condition.  "The skin can provide a visual window into inflammation that may be going on elsewhere in the body," she explained. Read on for more skin-related signs of long-COVID highlighted in the study, and for more on where the virus is starting to take over, check out 10 States on the Verge of COVID Surges.

COVID toes

Man looking at woman's foot

COVID toes are perhaps the best known skin-related coronavirus symptom. These are chilblain sores that look red, irritated, and inflamed, and they can serve as a dead giveaway that it's time to be tested. The good news? According to the aforementioned study, "COVID toes travel with relatively mild disease, with only 16 percent [of patients] hospitalized." And for more surprising COVID symptoms, find out why A Rash in This Spot May Mean You Have COVID.


Male doctor wearing a mask and gloves during a checkup with a young, 8 year old boy because of the COVID-19 outbreak.

If you notice a dry, scaly rash on your skin combined with any of the more common COVID symptoms, it's definitely time to get tested. This particular rash is typically red, pink, purple, or brown in color and can be shaped like a bullseye (similar to a rash from Lyme disease) or in smaller circles on the skin. One study noted that this rash was found most commonly in the COVID outbreak in Lombardy, Italy.


Close-up Of An African Man Scratching His arm

If you find that you suddenly break out in hives with no known allergy to explain it, this may very well be a COVID symptom. Speak with your doctor about any skin abnormalities you may notice, especially if you present with any other COVID symptoms. And for a comprehensive list of COVID warning signs, check out The Most Common COVID Symptoms You Could Have.

Papulosquamous eruptions

Female doctor wearing surgical mask examining infected patient. Mature healthcare worker checking mid adult man. They are at pharmacy.

These skin lesions are characterized by scaly papules or plaques—basically a red, scaly, inflamed skin rash. Doctors believe this is caused by "high levels of pro-inflammatory cytokines," as part of the patient's immune response to COVID-19. And for more warning signs of severe coronavirus, know that If You Have These 2 COVID Symptoms, You Could End Up in the Hospital.

Lauren Gray
Lauren Gray is a New York-based writer, editor, and consultant. Read more