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Nov 17, 2022 · Janeway lesions are skin patches that develop on the palms and feet. They usually last a few days to a few weeks before disappearing. Most cases of the condition indicate infective endocarditis, a heart infection. Sometimes, it can signify other conditions, such as systemic lupus erythematosus (SLE).
- What Are Osler Nodes and Janeway Lesions?
- What Is Bacterial Endocarditis?
- Osler Nodes
- How Did Osler Nodes Get Their Name?
- What Is The Cause of Osler nodes?
- What Tests Should Be done?
- What Is The Treatment of Osler nodes?
- Janeway Lesions
Osler nodes and Janeway lesions are two rare but well-known skin manifestations of bacterial endocarditis. They have also rarely been described in systemic lupus erythematosus (SLE), gonococcaemia (gonorrhoea), haemolytic anaemia and typhoid fever. They are important as they may help in the earlier diagnosis of a serious medical disorder.
Bacterial endocarditis is an infection of the lining of the heart caused by various bacteria. It most often affects the heart valves. The bacteria gain access to the heart via the bloodstream; an infection elsewhere in the body may or may not be apparent. While some bacteria can cause infection in normal heart valves, bacterial endocarditis more co...
Osler nodes are red-purple, slightly raised, tender lumps, often with a pale centre. Pain often precedes the development of the visible lesionby up to 24 hours. They are typically found on the fingers and/or toes. They can occur at any time during the course of endocarditis (usually subacute) and last from hours to several days.
The lesions were first described by French Physicians as ‘Nodosites Cutanees Ephemeres’ meaning ‘Cutaneous nodulesof short duration’ and by Dr Mullen of Hamilton. Parkes Weber later suggested that they are known as Osler nodes in recognition of the fact that Sir William Osler (1849-1919) had "first called attention to their full diagnostic importan...
The underlying cause of the nodes has been debated since Osler first proposed micro-embolisation as a cause (this is the scattering of tiny particles around the bloodstream). Early reports favoured an allergic or immunological cause, but more recent reports have isolated bacteria from within the nodules. A skin biopsy (histology) may reveal a neutr...
A careful search for endocarditis is made. This includes multiple blood cultures, other blood tests, urine tests, ECG, chest X-ray, and an echocardiogram (heart ultrasoundscan). The diagnosis may be elusive. A skin biopsymay be helpful to confirm the diagnosis of the Osler nodes.
Treatment of Osler nodes is aimed at the bacterial endocarditis and involves intravenous antibioticsand sometimes valve surgery. The skin lesions tend to heal spontaneously without scarring.
In contrast to Osler nodes, Janeway lesions are non-tender, often haemorrhagic (bleeding into the skin), and occur mostly on the palms and soles on the thenar and hypothenar eminences (at the base of the thumb and little finger respectively). They tend to last days to weeks before healing totally. Janeway lesions are more commonly seen in acute end...
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What are Janeway lesions?
What are Osler's nodes & Janeway lesions?
Are Janeway lesions a symptom of infective endocarditis?
How long do Janeway lesions last?
Jul 24, 2023 · Janeway lesions are irregular, non-tender, erythematous, or hemorrhagic macules or papules commonly found on the palm and soles, lasting days to weeks.[4] The presence of pain is conventionally a means to differentiate Osler nodes from Janeway lesions since accurate differentiation may be challenging, secondary to overlap in the appearance and ...
- Krishan Parashar, Steven Daveluy
- 2023/07/24
- 2021
Feb 19, 2013 · Janeway lesions are named after Theodore Caldwell Janeway (1872–1917), an American professor of medicine. They are nontender, erythematous or hemorrhagic macular or nodular lesions on the palms or soles. 1 They are commonly seen in acute endocarditis.
Janeway lesion; Specialty: Cardiology; Dermatology; Symptoms: Painless red flat papules on palms and soles. Usual onset: Sudden: Duration: Days to weeks: Causes: Infective endocarditis: Differential diagnosis: Osler's nodes
May 12, 2015 · Janeway lesions, on the other hand, are painless purple or brown erythematous macular lesions that usually affect the palms, soles, and fingers. They are sometimes purple or bleeding. They may last days or weeks, and tend to disappear with the resolution of the IE. 5
Jul 24, 2023 · Janeway lesions are irregular, non-tender, erythematous, or hemorrhagic macules or papules commonly found on the palm and soles, lasting days to weeks. The presence of pain is conventionally a means to differentiate Osler nodes from Janeway lesions since accurate differentiation may be challenging, secondary to overlap in the appearance and ...
