Janeway lesion
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| Janeway lesion | |
|---|---|
 | |
| Specialty | |
| Duration | Days to weeks |
| Causes | Infective endocarditis |
| Differential diagnosis | Osler's nodes |
Janeway lesions are non-tender, small erythematous or haemorrhagic macular, papular or nodular lesions on the palms or soles only a few millimeters in diameter that are often associated with infective endocarditis.[1][2]
They are however rare and frequently indistinguishable from Osler's nodes. Rarely, they maybe associated with Systemic lupus erythematosis (SLE), Gonococcemia (disseminated gonorrhoea), haemolytic anaemia and typhoid fever.[1]
Definition
Janeway lesions are painless, frequently haemorrhagic lesions seen most commonly on the palms and soles, particularly on the base of the thumb and little finger, and seen in infective endocarditis.[1]
Differential
Osler's nodes and Janeway lesions are similar and point to the same diagnostic conclusion. The only noted difference between the two is that Osler's nodes present with tenderness, while Janeway lesions do not.[2]
Pathophysiology
Pathologically, the lesion is described to be a microabscess of the dermis with marked necrosis and inflammatory infiltrate not involving the epidermis.[2]
They are caused by septic emboli which deposit bacteria, forming microabscesses.[3] Organisms may be cultured from the lesions.[4]
Janeway lesions are distal, flat, ecchymotic, and painless.[citation needed]
Diagnosis
Janeway lesions present as painless, non tender, subcutaneous maculopapular lesions on the pulp of the finger most commonly due to allergic or toxic inflammation of the vessel wall.[citation needed]
Not commonly seen, they are also often indistinguishable from Osler's nodes.[2]
They may last days to weeks before completely resolving.[1]
History
Janeway lesions are named after Edward Janeway (1841–1911), a prominent American physician, pathologist and contemporary of Sir William Osler, who initially described "peculiar skin lesions" in some people with endocarditis, in a paper published in 1899. The term was first used in 1923 by pathologist Emanuel Libman.[5]
See also
References
- ^ a b c d "Osler nodes and Janeway lesions | DermNet NZ". www.dermnetnz.org. Retrieved 2 October 2019.
{{cite web}}: CS1 maint: url-status (link) - ^ a b c d Farrior, J.B.; Silverman M.E. (1976). "A consideration of the differences between a Janeway's lesion and an Osler's node in infectious endocarditis". Chest. 70 (2): 239–243. doi:10.1378/chest.70.2.239. PMID 947688.
- ^ Mandell, Douglas, Bennett's Principles and Practice of Infectious Diseases, 7th ed., Churchill Livingstone (2009).
- ^ Patterson, James W. (2016). "8. The Vasculopathic Reaction Pattern". Weedon's Skin Pathology (4th ed.). Churchill Livingston. pp. 239–240. ISBN 9780702051838.
- ^ "Edward G. Janeway, Clinician and Pathologist" (PDF). Clinical Cardiology. 29 (8): 376–377. 2006. doi:10.1002/clc.4960290815. PMC 6654287.
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External links
Template:Eponymous medical signs for circulatory and respiratory systems