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Nail Splinter Hemorrhage
Aka: Nail Splinter Hemorrhage, Splinter Hemorrhage
- Pathophysiology
- Capillary leak at epidermal ridge
- Signs
- Red or brown Nail Longitudinal Band 1-3 mm long
- Typically start as red and then transition to brown or black
- Involves nail bed (not nail plate)
- Lines persist despite pressure applied to the nail
- Lines are due to blood that has leaked from the vasculature
- Causes
- Subacute Bacterial Endocarditis (classic)
- Only occurs in 15% of endocarditis cases
- Local Trauma (common cause)
- Psoriasis
- Onychomycosis
- Trichinosis
- Other conditions include renal, pulmonary and endocrine conditions
- Differential Diagnosis (cause similar appearing lesions)
- Rheumatoid Arthritis
- Systemic Lupus Erythematosus
- Dermatomyositis
- Scleroderma
- Antiphospholipid Syndrome
- Peptic Ulcer Disease
- Oral Contraceptive use or pregnancy
- References
- Degowin (1987) Diagnostic Exam, Macmillan, p. 697
- Tully (2012) Am Fam Physician 85(8): 779-87 [PubMed]