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Janeway lesion
Small red lesions of the hands and feet
Small red lesions of the hands and feet
| Field | Value |
|---|---|
| name | Janeway lesion |
| image | Janeway lesion.JPG |
| field | *Cardiology |
| symptoms | Painless red flat papules on palms and soles |
| onset | Sudden |
| duration | Days to weeks |
| causes | Infective endocarditis |
| diagnosis | Appearance |
| differential | Osler's nodes |
- Dermatology Janeway lesions are rare, non-tender, small erythematous or haemorrhagic macular, papular or nodular lesions on the palms or soles only a few millimeters in diameter that are associated with infective endocarditis and often indistinguishable from Osler's nodes.
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.
Differential
Osler's nodes and Janeway lesions are similar and point to the same diagnostic conclusion.
Pathophysiology
Pathologically, the lesion is described to be a microabscess of the dermis with marked necrosis and inflammatory infiltrate not involving the epidermis.
They are caused by septic emboli which deposit bacteria, forming microabscesses. Organisms may be cultured from the lesions.
Diagnosis
Janeway lesions present as red, painless macules and papules on the palms and soles.
They are not common and are frequently indistinguishable from Osler's nodes. Rarely, they have been reported in cases of systemic lupus erythematosis (SLE), gonococcemia (disseminated gonorrhoea), haemolytic anaemia and typhoid fever.
They may last days to weeks before completely resolving.
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 by internist and pathologist Emanuel Libman, who reported the lesions in his paper of 1906 and explained his reasoning for using the term "Janeway lesions" in a footnote in 1923. Osler never mentioned Janeway lesions. The inclusion into Osler's 1925 textbook came six years after Osler died.
References
References
- (2022). "Osler Node and Janeway Lesions". StatPearls Publishing.
- "Osler nodes and Janeway lesions {{!}} DermNet NZ".
- "Why Osler's Nodes are Painful while Janeway Lesions are Painless?".
- (2017). "Image of the month: 'Diagnostic hands': Janeway lesions". Clinical Medicine.
- Farrior, J.B.. (1976). "A consideration of the differences between a Janeway's lesion and an Osler's node in infectious endocarditis". Chest.
- Mandell, Douglas, ''Bennett's Principles and Practice of Infectious Diseases'', 7th ed., [[Churchill Livingstone]] (2009).
- Patterson, James W.. (2016). "Weedon's Skin Pathology". Churchill Livingston.
- Jordan Prutkin. (2006). "Edward G. Janeway, Clinician and Pathologist". [[Clinical Cardiology]].
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