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Histopathology of persistent long COVID toe: A case report
Michael S Nirenberg1, Luis Requena2, Carlos Santonja3
1Friendly Foot Care, P.C., Crown Point, Indiana, USA.
Journal of Cutaneous Pathology
|April 2, 2022
Summary
This study reports a rare case of "long COVID toe" in a man with presumed SARS-CoV-2 exposure. The persistent toe cyanosis was linked to capillary thrombosis and pernio-like pathology, highlighting a long-term vascular complication.
Area of Science:
- Dermatology
- Infectious Diseases
- Pathology
Background:
- The COVID-19 pandemic revealed diverse cutaneous manifestations.
- Skin lesions associated with SARS-CoV-2 infection include pseudo-chilblain, vesicular, urticarial, maculopapular, and livedo/necrosis patterns.
Observation:
- A 59-year-old obese male presented with painful, persistent toe cyanosis following suspected SARS-CoV-2 exposure.
- Despite initial respiratory symptoms, serological and PCR tests for SARS-CoV-2 were negative.
- Family members had confirmed SARS-CoV-2 infection, with one fatality.
Findings:
- Histopathological examination of toe biopsy revealed capillary thrombosis, endothelial swelling, telangiectasia, and pernio-like changes.
- These findings suggest a thrombotic vasculopathy contributing to the prolonged cyanosis.
- This represents the first biopsy-proven case of "long COVID toe" with these specific pathological features.
Implications:
- This case underscores the potential for prolonged vascular complications, like "long COVID toe," following SARS-CoV-2 exposure.
- It highlights the importance of considering thrombotic vasculopathy in persistent cutaneous symptoms post-infection.
- Further research is needed to understand the mechanisms and long-term prognosis of such vascular manifestations.
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