Dr Raine added: This type of blood clot can rarely occur naturally in unvaccinated people as well as in people with Covid-19. This can be interpreted as meaning that COVID toes are a reaction to the way your immune system is handling the virus., In contrast, some of the other dermatologic conditions travel with much more severe COVID-19," Freeman says. Other than a low platelet count, laboratory data are typically normal. Many genetic conditions can affect blood clotting. Last medically reviewed on April 25, 2022, A hematoma occurs when blood leaks from a large blood vessel. Rash-like morbilliform lasted a median of seven days, and urticarial (hives) lasted a median of four days in COVID-19 patients. THE AstraZeneca Covid vaccine has been linked with a bleeding condition that can cause excessive bruising and a red spotty skin. Other viruses and diseases cause skin symptoms, too, like measles and chickenpox, but symptoms usually go away once a patient has recovered. We use your sign-up to provide content in ways you've consented to and to improve our understanding of you. An arterial clot can block blood and oxygen from reaching your vital organs and this in turn can lead to tissue damage. COVID toes, which is characterized by swelling, discoloration or painful bumps on the toes. Is . Whitman PA, Crane JS. Colleen Murphy is a senior editor at Health. Some signs that an individual bruises more easily than an average person include: Numerous factors can cause a person to bruise more easily. Two had COVID toes for more than 130 days. The timing of thrombocytopenia varied, with some patients developing it early in their hospital course and others developing it days after admission. This rash appears on the neck and on the part of the chest that is exposed to sunlight. Dr Raine said that while the MHRA continued to investigate reports of blood clots, as a precautionary measure it would advise "anyone with a headache that lasts more than four days after vaccination or bruising beyond the site of vaccination after a few days to seek medical attention". Data entered into a global registry of nearly 1,000 patients across 39 countries showed that COVID-19 long-hauler patients continue to experience skin-related symptoms long after their initial infection has cleared. Stasi R, Provan D. Management of immune thrombocytopenic purpura in adults. What is the latest research on the form of cancer Jimmy Carter has? As a result, red blood cells are lysed during times of oxidative stress.9. Very forceful blows can damage bones, causing deep bleeding and bruises that take several weeks to heal. Here are four of the most common eye problems that may develop after COVID infection, according to the new analysis. This causes the characteristic black or purple color of a bruise. A 35-year-old woman with a medical history significant only for recently diagnosed essential hypertension presented to an urgent-care facility with easy bruising, petechiae, and gingival bleeding. Often, there are no symptoms in the early stages, but a person may notice: Petechiae may not be visible on dark skin, but a person may see them on areas with lower levels of melanin, such as the forearms. Klok FA, Kruip MJHA, van der Meer NJM, et al. According to our 2018 patient survey, "Living with Leukaemia", frequent bruising and bleeding precedes a diagnosis of leukaemia in 24% of patients. Immune thrombocytopenia purpura secondary to COVID-19. The rash pictures are divided into these main categories: According to the BAD, since they don't look like any other skin condition, COVID toes and fingersaka digitsmight be the most telltale COVID rash. The UK medicines regulator today said people should . Typical laboratory findings include prolonged prothrombin time and partial thromboplastin time, low levels of fibrinogen, increased levels of D-dimer, and findings consistent with microangiopathic hemolytic anemias.5. Some people bruise more easily than others, and the bruising can take longer to heal. What Should We Expect From Long COVID Treatment? 5. Int J Lab Hematol 2014; 36(3):269278. doi:10.1002/jmv.26138CrossRefGoogle Scholar, 28. During the healing process, the bruise will change color before fading away. Home remedies may be enough, but, Here is a look at petechiae, small nonraised hemorrhages that appear on the skin. CORONAVIRUS symptoms may now include bruising and dark sores around the human skin, a new alarming study on COVID-19 has indicated. We do not endorse non-Cleveland Clinic products or services Policy. doi:10.3343/alm.2016.36.6.505CrossRefGoogle Scholar, 7. They may wish to discuss the risks and benefits of continuing treatment. A bruise develops when blood vessels become damaged, and blood leaks into tissues under the skin. It is a symmetrical rash with numerous reddish blotches or bumps over the body. Small and hard to find veins. 16:43, Tue, Apr 21, . Disorders of decreased production include bone marrow diseases, such as myelodysplastic syndromes and aplastic anemia, and liver disease. Health Authorities Call For More Research on Long COVID, People Hospitalized for COVID More Likely to Develop Long-term Conditions, Life as a Long-Hauler: COVID Leaves Former English Professor at a Loss for Words, Some COVID Long Haulers Are Being Diagnosed With POTS, New analysis reveals long-hauler COVID-19 patients with prolonged skin symptoms. [MAPPED]We must never forget the heroes of the lockdown, says VANESSA FELTZ[COMMENT]. And 21% of the people said that their rash was the only symptom of COVID-19 they experienced. Disorders of platelet destruction or consumption include immune thrombocytopenic purpura and hemolytic processes. Middleaged patients suffer more . Symptoms of COVID-19. Papulosquamous eruptions lasted a median of 20 days, but one COVID-19 long-hauler had the symptom for 70 days.. The severity of a COVID-19 case is associated with different types of skin symptoms. Severe immune thrombocytopenic purpura in critical COVID-19. And while rashes might be less common than other signs of COVID-19, the study authors point out that skin changes can be easily recognized, which may help with virus detection and contact tracing. A doctor can carry out tests to see whether a person has a vitamin deficiency. Usually, the rash is itchy. "One example of that is something called retiform purpura, which are net-like, bruise-like eruptions that are actually caused by clots.". Known as immune thrombocytopenic purpura (ITP), the condition appear In most cases, a person who bruises easily is unlikely to develop complications after a bruise. But as Health reported, dermatologists have seen transient livedo reticularis in patients with COVID-19, meaning the rash is brief or temporary. By Lauren M. Granat, DO, MS; Achintya D. Singh, MBBS, MD; Matthew Cortese, MD, MPH; Vicente Velez, MD, FACP, FHM; and Alan Lichtin, MD, Cleveland Clinic is a non-profit academic medical center. In a statement the council said: Numerous cases are being observed in different countries; Italy, France, Spain. Primary immune thrombocytopenic purpura is due to production of autoantibodies against platelets, whereas the secondary form can be triggered by many different conditions, including viral illnesses and autoimmune diseases.7,8, Glucose-6 phosphate dehydrogenase deficiency is an X-linked genetic disorder that can lead to hemolytic anemia after ingestion of certain foods or drugs. However, a few things do help: 1. pace yourself: adjust the return to normal activities to your energy levels . For this reason,Brits have been told to carry on taking the vaccinebecause the benefits of protection against Covid outweighs and potential risk of the jab. To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter. Terpos E, Ntanasis-Stathopoulos I, Elalamy I, et al. All patients, excluding one who died shortly after developing thrombocytopenia, were treated with intravenous immunoglobulin, corticosteroids, or both, with hematologic recovery in all reported cases. 9500 Euclid Avenue , Cleveland , Ohio 44195 | 800.223.2273 | TTY 216.444.0261, Effects of COVID-19 on Blood Sugar and Type 2 Diabetes, Optimal Management of High Risk Immunocompromised Patients in the COVID-19 Era, Real World Experience with Tixagevimab/Cilgavimab in B-Cell-Depleted Patients, New Onset Eosinophilic Fasciitis after COVID-19 Infection, Glucose-6-phosphate dehydrogenase deficiency, Hemolysis (reticulocyte count > 2.5%, undetectable haptoglobin, or indirect bilirubin > 2 mg/dL). Diagnostic value of cutaneous manifestation of SARS-CoV-2 infection. One day after receiving her first dose of Moderna's Covid vaccine, Luz Legaspi, 72, woke up with bruises on her arms and legs, and blisters that bled inside her mouth. By Laura Hensley A peripheral blood smear revealed thrombocytopenia and normal-appearing white and red blood cells, indicative of immune thrombocytopenic purpura (Figure 1). Leisman DE, Deutschman CS, Legrand M. Facing COVID-19 in the ICU: vascular dysfunction, thrombosis, and dysregulated inflammation. Patients with scores of 5 or higher should be empirically treated for thrombotic thrombocytopenic purpura with plasma exchange, as this condition can be life-threatening if untreated. Here are some of these symptoms, from the most common to the least: 1. View our online Press Pack. Older adults often bruise more easily, because the skin becomes less flexible with age, and there is less fat to protect the blood vessels. BMJ Case Rep 2020; 13(7):e236815. Ways of reducing the risk of bruising include: Senile purpura does not have links with any serious health condition, but it may increase the risk of skin tears. Factors that increase the risk include older age, having a condition that affects blood clotting, and using medications such as blood thinners. bruising and bleeding are common, Dr. Bussel added . The ITP syndrome: pathogenic and clinical diversity. Some people are having delayed reactions to their first dose of a Covid vaccine, with their arms turning red, sore, itchy and swollen a week or so after the shot . What about COVID-19 vaccines for kids? Similar instances have also been reported across Europe including in Spain and France. First aid for a bruise after an injury involves: Other treatment options include using pain relief medication, such as ibuprofen. That's because over time, the sun slowly weakens your skin and the tiny blood vessels . What is vitamin K deficiency bleeding? Gastrointestinal problems including digestive issues and nausea are another symptom reported by long-term COVID sufferers. The disorder is called thrombocytopenia and usually causes people to bruise easily, develop rashes and experience excessive bleeding from just a minor injury. (2018). Symptoms of a bruise include: Pain or tenderness (sore feeling) when you touch the bruise. The skin around may be thinner and less elastic. The coagulation and fibrinolytic processes may be inappropriately activated during sepsis or in other conditions such as pregnancy or malignancy. When it comes to the skin symptoms long-haulers are experiencing, Freeman says theres likely multiple factors at play. Heart failure: Could a low sodium diet sometimes do more harm than good? Iron: Iron is vital for healthy blood cells. In the emergency department, repeat testing confirmed that her platelet count was indeed only 3.0 109/L, while the rest of her complete blood cell count values were unremarkable (Table 1). Exact date yellow weather warning for snow and ice forecast to hit UK - will you be affected? She was admitted to the hospital for two days, during which she received 2 doses of oral prednisone 1 mg/kg/day. It has recently come to light that COVID-19 symptoms may manifest on your feet too. People who think they're having skin symptoms of COVID-19 should wear a mask, isolate and arrange a telehealth appointment with their health care provider to address their symptoms, according to Mary Stevenson, MD, assistant professor of dermatology at NYU Langone Health. Most often they occur in your legs and your feet and can sometimes happen in your brain - in this case they can lead to a stroke. Post-COVID conditions are a wide range of new, returning, or ongoing health problems that people experience after being infected with the virus that causes COVID-19. Liver disease can affect blood clotting, which can increase the risk of bleeding and easy bruising. The measles virus, for example, causes fever and flu-like symptoms and spreads throughout the body. But as experts began to understand the disease better, it became clear that many health changes could indicate someone has the virusloss of taste or smell, diarrhea, and headache, just to name a few. This damage results in symptoms that may include numbness, weakness, vertigo, paralysis, and involuntary muscle contractions. Plasma exchange is considered a first-line treatment for thrombotic thrombocytopenic purpura and serves to replace the deficient ADAMTS13 molecule. Information for patients. Most patients included in the survey had no history of skin conditions. Susanne R. Gulliver, BA, MPH, a senior epidemiologist and research and operations manager at NewLab Clinical Research Inc. in St. John's, Newfoundland and Labrador, tells Verywell that many other viruses or diseases can also cause skin symptoms, as seen with measles and chickenpox. A repeat complete blood count after she finished her course of steroids, five days after her initial presentation, revealed a platelet count of 268 109/L. 2004-2023 Healthline Media UK Ltd, Brighton, UK, a Red Ventures Company. DIC is a condition where blood clots form throughout the body - blocking small blood vessels. One day after receiving her first dose of Moderna's Covid vaccine, Luz Legaspi, 72, woke up with bruises on her arms and legs, and blisters that bled . Any part of the body can be affected, including the face. This may include adverts from us and 3rd parties based on our understanding. There are so many different types of skin findings being reported that . Without enough vitamin C in the body, random bruising can occur. You can unsubscribe at any time. Coronavirus Symptoms vs Cold: How Do They Compare? However, if you get any of the following after receiving the COVID-19 Vaccine AstraZeneca: breathlessness, pain in the chest or stomach, swelling or coldness in a leg, 1; severe or worsening headache or blurred vision after vaccination, persistent bleeding, multiple small bruises, reddish or purplish spots, or blood blisters under the skin, This is far lower than what would be expected, experts say. In general, the rashes are usually "very itchy." (2021). Sarah Jacoby. Lancet Haematol 2017; 4:e157164. Cardiovascular health: Insomnia linked to greater risk of heart attack. (Odd but hopefully descriptive enough). When this happens, blood leaks out of the vessels and initially appears as a dark mark. But it's a good idea to get a bruise checked out by your doctor if it: Shows no signs of improvement after a week. Chambellan A, Chailleux E, Similowski T, ANTADIR Observatory Group. But what the researchers found to be most striking was that 17% of the respondents said that their skin changes happened before any other COVID-19 symptoms. Anemia and the liver. Platelet numbers drop causing easy . doi:10.1016/j.thromres.2020.04.013CrossRefPubMedGoogle Scholar, 18. The BAD said the rash could last several months before clearing. Thromb Haemost 2001; 86(5):13271330. Thrombotic thrombocytopenic purpura: diagnostic criteria, clinical features, and long-term outcomes from 1995 through 2015. Dr June Raine, chief executive of the Medicines and . Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. This is evident with the various symptoms long-haulers experience, includinglonger-standing cardiac complications, neurological effects, and chronic fatigue, Freeman says. And while COVID-19 isn't the only viral infection to affect the skin, Dr. Bataille and Falchi said that, compared to other viral infections, the rashes with COVID-19 seem to be more common and more diverse. 2021;184(5):880-887. doi:10.1111/bjd.19807. Shannon Hampton The West Australian. On dark skin, bruising may also appear red or purple, or it may show as a darker area than the surrounding skin, depending on the persons skin tone. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Sun exposure can also increase the risk. (2021). According to a 2021 study published in the British Journal of Dermatology, there is an association between skin rashes and a positive COVID-19 swab test result. They usually heal within 2 to 4 weeks. Overview. As Connecticut-based dermatologist Mona Gohara, MD, told Health, "It's not unique that a virus would give you a skin rash." The link with COVID-19 was eventually made and the chilblain-like rash was coined COVID toes. Bruises range in size, shape and color depending on the type of bruise, cause and location. Long-haulers or people experiencing long-term symptoms from COVID-19 are still being studied. pmid:11816725PubMedGoogle Scholar, 8. The causes of thrombocytopenia can be divided into disorders of decreased platelet production and disorders of increased platelet consumption or destruction. "If you have other symptoms like respiratory issues or extensive skin lesions, you need to be triaged either virtually or in person. Some people bruise more easily than others. But as experts began to understand the disease . New research shows that 12 weeks after infection, 75% of those hospitalized with Covid-19 still have a range of severe and disabling symptoms. They may also develop large bruises after minor injuries or have bruises that take many weeks to heal. The first set of side effects are 'local', presenting themselves near the injection site within 24-48 hours. Blood clots in the arteries leading to the brain can cause a stroke. (The low platelets with this complication make a typical clot treatment, the blood thinner . In addition, there have been multiple case reports of COVID-19induced severe secondary thrombocytopenia (Table 5).2228The patients all had typical symptoms of COVID-19 such as cough, fever, or shortness of breath. Editors note: This article originally appeared in the Cleveland Clinic Journal of Medicine. Centers for Disease Control and Prevention. doi:10.1182/asheducation-2008.1.212CrossRefGoogle Scholar, 10. It can appear during or after the infection and typically lasts for an extended period. Hematological findings and complications of COVID-19. N Engl J Med 2020; 383(2):120128. There are a number of risk factors for this kind of clot including cancer, obesity, low blood pressure in the brain and inflammatory bowel disease. Some other medications may weaken or change the behavior of blood vessels, worsen inflammation, or otherwise increase the risk of bleeding. Many patients continue to have ongoing symptoms well after their initial SARS-CoV-2 infection. The most common include the following: People tend to bruise more easily with age, because blood vessels weaken, and the skin thins. But, for some people, those symptoms can be so intense . A WA grandmother is in hospital after developing severe bruising after receiving the AstraZeneca COVID-19 vaccine, with health authorities investigating to see if her illness is related to the jab. For this reason, Brits have been told to carry on taking the vaccine because the benefits of protection against Covid outweighs and potential risk of the jab. Since being first detected in late November 2021, the Omicron variant has caused a surge in Covid cases across the nation, forcing state officials to reimplement mask mandate rules and stress testing. When blood clots prevent nutrients from getting to the retina, the . Minor bruises often heal in a few days. Here, find out some reasons one person may bruise more easily than another. Within a day or two, it turns purplish or black and blue. Different forms of MS can follow variable courses from relatively benign to life-threatening. Laura Hensley is an award-winning lifestyle journalist who has worked in some of the largest newsrooms in Canada. What is a black eye and what can I do about it? Kidney disease. Side effects from the Johnson & Johnson COVID-19 booster. These are purple-coloured lesions that usually appear around the toes and that usually heal without leaving marks on the skin. The laboratory findings commonly seen in thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, disseminated intravascular coagulation, and immune thrombocytopenic purpura are summarized inTable 2. Klicken Sie auf Alle ablehnen, wenn Sie nicht mchten, dass wir und unsere Partner Cookies und personenbezogene Daten fr diese zustzlichen Zwecke verwenden. doi:10.1080/09537104.2020.1754383CrossRefGoogle Scholar, Cleveland Clinic is a non-profit academic medical center. Hepatobiliary manifestations of anemia. Five months in at day 150 she still had severe nausea, extreme fatigue, bulging veins, excessive bruising, an erratic heartbeat, short-term memory loss, gynecological problems, brain fog and . Are 'COVID Toes' a Real Symptom of the Virus? The researchers said that their "study strongly supports the inclusion of skin rashes in the list of suspicious COVID19 symptoms." Soft tissue injuries. To see all content on The Sun, please use the Site Map. In Freemans research, data showed that different symptoms lasted various amounts of time. The MHRA (Medicines & Healthcare products Regulatory Agency) advised that Brits experiencing severe bruising after the jab should also seek help as it could be a sign of a rare blood clot. For this week's FAQ Friday, we're looking at the plight of these "long haulers . . DOCTORS are warning about a worrying side effect that Omicron patients should watch out for - even after they've recovered from Covid. The skin symptoms that seem to be linked to inflammation include COVID toes, or pernio/chilblains. "However, for some, the rashes are quite recurrent and can come and go for weeks and months. Some causes of bruising include: Vitamin C and Vitamin K deficiency. Im a little worried. What You Need to Know, This Makeup Artist With Chronic Eczema Doesn't Hide Her Flare-UpsShe Makes Them Stand Out. Anyone suffering with a headache more than four days after receiving a Covid-19 vaccine should call their doctor, medical experts have advised. doi:10.1007/s00134-020-06059-6CrossRefPubMedGoogle Scholar, 22. Br J Haematol 2020; 190(2): e61e64. She has extensive experience with interviewing healthcare providers, deciphering medical research, and writing and editing health articles in an easy-to-understand way so that readers can make informed decisions about their health. COVID toes lasted about two weeks in patients, but six patients in the registry had symptoms lasting at least 60 days. According to the Mayo Clinic, sudden, sharp chest painsaka pleurisymay indicate that the lung walls are inflamed. A Look at the Research, COVID-19 Immunity May Last 5 Months After Recovery, Study Finds, What to Know About Fibromyalgia and COVID-19. Transcultural concepts in nursing care. Both proteins are important for blood clotting. The body uses vitamin C in creating collagen, an essential part of the structure of blood vessels. Vasculitis refers to a group of conditions that cause inflamed blood vessels. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. For other inquiries, Contact Us. Sarah Blesener for The New York Times. (2017). They are more common in people with light skin, but anyone can develop them. A few people developed a rare blood disorder after getting a COVID-19 vaccine, but experts have been looking for the link. Blood 2009; 113(26):65116521. Blood 2009; 113(11):23862393. March 3, 2021. A person with this condition has little or no von Willebrand protein, which is important for blood clotting. Synthetic hormone treatment can improve blood clotting in people with the condition. It causes dark purple bruise-like lesions on the skin and is most likely to develop on the arms and hands. Most bruises form when small blood vessels (capillaries) near the skin's surface are broken by the impact of a blow or injury often on the arms or legs. The symptoms will be present from birth and can affect babies and young children. The Council of Podiatrists urges its Colleges and its members to be very vigilant because this may be a sign of COVID-19 detection that can help to avoid contagion. The skin changes appeared at the same time as other COVID19 symptoms for 47% of the survey respondents and after other COVID-19 symptoms for 35% of the survey respondents. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. It certainly begs the question of why do some patients seem to have these really long-standing, persistent inflammatory effects? With COVID toes, we're seeing this kind of persistent inflammation, she says. (2021). Br J Dermatol. In people with diabetes, wounds, including bruises, can take longer to heal. doi:10.1046/j.1523-1755.2001.060003831.xCrossRefPubMedGoogle Scholar, 13. The body said that patients had developed this condition alongside low platelets. Is the ketogenic diet right for autoimmune conditions? Heat rashes, for example, are a type of vesicular rash. doi:10.1542/peds.2020-1419Abstract/FREE Full TextGoogle Scholar, 24. They can include the following: People taking medication who notice an increase in bleeding or bruising should ask a doctor whether their medication can cause bleeding. Loss of smell, dizziness, and rash are among the symptoms of COVID-19 that people may miss. redness. Temporary relief of Bruising or Muscle Soreness. Your provider will ask you some questions, she says, "about your diet, activities that could cause injury, and medications or supplements you take regularly for example, ibuprofen, aspirin, fish oil, and certain antibiotics can cause easy bruising. We avoid using tertiary references. What are the symptoms of an arterial clot? Learn more about the symptoms of liver disease here. In most cases, a person who bruises easily is unlikely to develop complications after a bruise. urine that's foamy or bloody. Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. There are different types of leukemia, and symptoms vary. Or anyone with a new continuous cough for more than an hour, or more than three coughing episodes in 24 hours, to stay at home and use the NHS 111 service. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources. doi:10.1111/ijlh.12214, 2. Blood Adv 2017; 1(10):590600. In view of the pertinent negative findings described above and the temporal relationship between her symptoms and her positive SARS-CoV-2 test, we concluded that her otherwise-asymptomatic COVID-19 was the trigger for her severe thrombocytopenia. doi:10.1111/trf.15954CrossRefGoogle Scholar, 5. READ MORE:UK schools reopening: Pupils won't return to school until AFTER summer, The Council wants to convey a message of reassurance to parents and possible victims, given the benign nature of the lesions, and to remember that they should monitor the appearance of the other clinical symptoms characteristic of COVID-19, such as cough, fever, respiratory distress.. doi:10.1007/s12185-020-02931-9CrossRefGoogle Scholar, 27. swollen ankles and feet. Itching that leads to bruising. According to Dr. Bataille and Falchi, the rashes that may be associated with COVID-19 have no long-term effects, with most clearing up. Usually with other viruses or diseases, like measles, skin symptoms clear once the disease goes into remission and the lesions heal, Gulliver says. All of the following are treatment options for severe secondary immune thrombocytopenic purpura except which one? This service is provided on News Group Newspapers' Limited's Standard Terms and Conditions in accordance with our Privacy & Cookie Policy. What are the symptoms of thrombocytopenia? It looks like this: Usually, this type of rash lasts a long timesometimes, it's even permanent. Causes include age, medications, and vasculitis. Home of the Daily and Sunday Express. Included is detail on what they look like and when to contact a, Purpura and petechiae are discolored spots of skin that result from leaking blood vessels. Bleeding and bruising (thrombocytopenia) and cancer treatment. Medical conditions such as hemophilia, Cushing syndrome, thrombocytopenia, von Willebrand disease, and kidney or liver disease. Zander CB, Cao W, Zheng XL. It's actually hard to think of another virus that causes so many different types of skin findings.. "The Sun", "Sun", "Sun Online" are registered trademarks or trade names of News Group Newspapers Limited.
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