My symptoms are the same as Steve-en (covid?)

Hi,
I’ve decided ti write after reading Steve-en’s post.
Last winter I’ve started to develop chilblains; I often have them in winter but this year they have been more intense. Then I’ve started to note very red toes in the evening, but later, with sunny days I’ve realized my toes becoming red and a bit swollen just walking barefoot in the sun. They need a couple of hours to come back normal. When they are not red, they look a bit enflamed like if chilblains were still there. My daughter, 14 yrs old, has suffered from Covid toes in the same period I hade chilblains. Neither she nor I have had covid anyway. My daughter right now is suffering red toes but not as red as mine. I don’t have pain but sometimes I feel my soles very hot but they are fresh if I touch them. I will see a dermatologist. I just would like to write my experience because I feel possible a relation with covid. Any suggestion would be appreciated. Thank you

The activation pattern for erythromelalgia is symptoms are elicited by heat and alleviated by cold. If the erythema (redness) you are experiencing follows that pattern, you may have erythromelalgia. An easy test would be to place your feet in front of a heater to see if symptoms occur. Conversely, you could place you feet on ice packs or submerged in ice water to see if symptoms dissipate.

COVID-19 infection is known to cause neurological complications. COVID-19 could potentially worsen erythromelalgia in individuals already suffering or trigger it in those susceptible. Which is why it’s important to be vaccinated against COVID-19, particularly if you have erythromelalgia.

Thank you for your answer. I don’t know if I have erythromelalgia. When my feet are red they are cool, not cold not hot. Sometimes I have red toes with no pain, sometimes a sensation of hot feet that is not real. I’ve had chilblains, this is sure, like every winter, bit this time they lasted more and made my toes discolored.

Erythromelalgia is associated with erythema (redness) that is accompanied by an extreme increase in skin temperature. The skin isn’t just red, but also very hot. Absent that, it’s unlikely you have erythromelalgia.

Thank you again. So I have to understand why my feet become so red when they are under the sun or in my shoes, or after a shower but without pain nor heat (they are just lightly warm). I have dystonia so maybe it could be another neurological issue, since sometimes I feel my feet hot when they are cool. Could a neurologist be the doctor for me? Anyway I have chilblains since ages, and they seem involved in this…:thinking:

Is it uncomfortable but below the level of discomfort you’d call pain?

On a pain scale of 0-10, where 0 is no discomfort at all and 10 is the worst pain you’ve ever felt, how would you describe it?

0, by now. Not painful at all. I just feel a sensation of heat but not when I flare. Maybe much later…
My feet become red with heat, then they stay red for a couple of hours. No pain no heat during this time. If I have my shoes on and I can’t see it, I don’t realize that my feet are red…

It sounds like you’re looking for a problem where there isn’t one. If the redness causes no discomfort, it is a cosmetic issue. Erythromelalgia is a pain disorder.

Thank you for your time. I’m just surprised about the crab nuance of my feet. I understand there is a great difference between pain and no pain, anyway I was wondering if there could be some common point with my situation (red, chilblains).
Thank you again

Hello,
I suggest watch and wait approach. My EM symptoms reared its ugly head after a chillblain episode, which was the first for me.
Shortly after , some one asked me me, why are your toes red, I hadn’t noticed.
About a month later I had the hot burning sensation in my toes.
Hopefully for you this will not be the same, but you would know as the pain is like being on fire.

Hi Aprile,

As you can read, lots of folks have different types of symptoms. As CarterDK mentioned, the key with EM is that your feet will increase in temperature. I developed what looked like pernio (to about 3-4 experienced doctors, and a biopsy) in the beginning, and the thought was it was COVID toes - since I never, ever had anything like that before, despite being in very cold weather.

In the beginning, there were no temperature changes in the toes, just redness and with discomfort you would get from a rash. Then i developed a combination of cold episodes (constriction of blood vessels), where they would turn almost blue and very, very hot episodes (the toes were burning hot like you would get with a fever, and of course red). The hot episodes occurred daily, triggered by heat, worse in the evenings and with my feet lowered. They would improve by raising my feet up high.

The fact that your daughter had the same symptoms when yours worsened could mean that you both had had the infection, or some other event common to both of you at that time. Did she get tested? I do not know where you live, but you could get a test to see if you were infected. A negative test does not exclude infection though, as many with “COVID toes” test negative. In kids, the antibody responses are different than adults, and the commercial kits do not detect the antibodies kids tend to make. Extensive antibody studies have not been done in adults with COVID toes. Also, the antibody levels go down quickly even in kids who test positive using research level testing (not what you get in a typical lab). So you have to repeatedly test in the weeks where symptoms develop and hopefully hit the right time point to really know.

A neurologist could be helpful for you, if your feet feel like they are burning hot (neuropathy), but are not actually hot to the touch. Also, but much more rare, is a condition called CRPS, where the color of the skin can change, there can be neuropathic pain like you describe, and swelling. This typically follows an injury though, and with CRPS temperature also can change. Things to bring up when you see a knowledgeable dermatologist and/or neurologist.

Not to mention the pain level for CRPS is extraordinarily high. People with CRPS often describe their pain as the worst they’ve ever felt. I was evaluated for CRPS initially and flatly told my doc— I don’t think my pain level is severe enough for it to be CRPS.

I have chilblains each winter since ages. I’m a dancer (so my feet have to work a lot - but no injuries) and when I was a teen I suffered of anorexia. This early spring I’ve noted that my toes were not healed as usual, with tiptoes a bit red. Moreover sometimes (evening, or with much walking) my toes were red. With summer I’ve noted that this red appears also with the sun, sometimes in the evening). The red is intense, toes and external part of the foot, but not painful, not hot. This winter, because of the lockdown, my habits had to change. My work has become much more sedentary. And I know that COVID can interfere with circulation too. I’ve also read that there is a condition called acrocyanosis which can turn in erythrosis (no pain, just red) with hot. I’ve always had cold feet with toes tending


to become violet. Steve-em, thank you for your answer. How are you now? I’m from Italy. I will get a covid test, again.