Splinter Hemorrhages-Their Clinical Significance

Idiopathic splinter hemorrhages

“…In diabetes mellitus, it accounted for over 70% of the cases in one study. 2 Classical lesions associated with subacute bacterial endocarditis include petechiae and splinter hemorrhages. 9,12 Splinter hemorrhages associated with endocarditis may represent damage from inflammation of the blood vessels (vasculitis), or microscopic clots that damage the small capillaries (microemboli).…”

“…Nonetheless, subungual splinter hemorrhages in patients with minimal supporting evidence for bacterial endocarditis by history, physical examination, or laboratory tests, in the face of negative blood cultures, have no clinical significance. 2 Subungual splinter hemorrhages can also be seen in the antiphospholipid syndrome. [13][14][15][16][17][18] Furthermore, a patient with cholesterol crystal embolization demonstrated splinter hemorrhages of multiple fingernails and toenails as part of her clinical presentation.…”

“…20, 21 Peritoneal dialysis was identified as the single most frequently encountered factor in one cohort of patients with splinter hemorrhages. 2 Martens et al 22 described a patient who developed splinter hemorrhages following radial artery puncture. Drug-induced splinter hemorrhages and onycholysis have been reported after the use of tetracycline hydrochloride.…”

“…[2][3][4][5] Dermatologic conditions associated with splinter hemorrhages include several primary nail disorders, such as onychomycosis and psoriasis. Splinter hemorrhages of unknown etiology have also been reported.…”

Splinter hemorrhages of the nails: a systematic review of clinical features and associated conditions

“…In 1920, Sir Thomas Horder reported “a minute petechia in the form of a vivid linear splash of red at the side of the bed of a fingernail” that occurred in a patient with bacterial endocarditis . The label “splinter hemorrhage” (SH) stuck, and the condition has been estimated to occur at a frequency of around 19%, and to have statistically greater incidences in male than in female subjects and in African‐Americans than in White people . Despite numerous reports, this frequently observed sign remains a useful although not specific clinical finding that has been associated with conditions of varying severity, including but not limited to infective endocarditis, vasculitis, antiphospholipid syndrome, chronic meningococcemia, tyrosine kinase inhibitors, trauma, activities of daily living, and chronic or acute exposure to high altitude .…”