“…Edward Janeway in 1899 and William Osler in 1909 described some of these skin findings, 58 which are now commonly called Janeway lesions and Osler nodes, but with differing and often conflicting definitions. 59,60 Perhaps the most widely adopted distinction characterizes Osler nodes as painful papules on the tips of the fingers and toes and Janeway lesions as painless macules on J AM ACAD DERMATOL VOLUME 60, NUMBER 1 the palms and soles. Skin biopsies or aspirates from several of these lesions have disclosed such features as neutrophilic inflammation (sometimes forming microabscesses), vascular occlusion, septic vasculitis, microemboli, and evidence of the infecting organism on stains and/or culture of the specimens.…”