Janeway lesions

Jump to navigation Jump to search
Janeway lesions
Janeway Lesions: Flat, painless, erythematous lesions seen on the palm of this patient's hand. Frequently associated with bacterial endocarditis.
(Image courtesy of Charlie Goldberg, M.D.)

WikiDoc Resources for Janeway lesions

Articles

Most recent articles on Janeway lesions

Most cited articles on Janeway lesions

Review articles on Janeway lesions

Articles on Janeway lesions in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Janeway lesions

Images of Janeway lesions

Photos of Janeway lesions

Podcasts & MP3s on Janeway lesions

Videos on Janeway lesions

Evidence Based Medicine

Cochrane Collaboration on Janeway lesions

Bandolier on Janeway lesions

TRIP on Janeway lesions

Clinical Trials

Ongoing Trials on Janeway lesions at Clinical Trials.gov

Trial results on Janeway lesions

Clinical Trials on Janeway lesions at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Janeway lesions

NICE Guidance on Janeway lesions

NHS PRODIGY Guidance

FDA on Janeway lesions

CDC on Janeway lesions

Books

Books on Janeway lesions

News

Janeway lesions in the news

Be alerted to news on Janeway lesions

News trends on Janeway lesions

Commentary

Blogs on Janeway lesions

Definitions

Definitions of Janeway lesions

Patient Resources / Community

Patient resources on Janeway lesions

Discussion groups on Janeway lesions

Patient Handouts on Janeway lesions

Directions to Hospitals Treating Janeway lesions

Risk calculators and risk factors for Janeway lesions

Healthcare Provider Resources

Symptoms of Janeway lesions

Causes & Risk Factors for Janeway lesions

Diagnostic studies for Janeway lesions

Treatment of Janeway lesions

Continuing Medical Education (CME)

CME Programs on Janeway lesions

International

Janeway lesions en Espanol

Janeway lesions en Francais

Business

Janeway lesions in the Marketplace

Patents on Janeway lesions

Experimental / Informatics

List of terms related to Janeway lesions

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Janeway lesions are non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms or soles only a few millimeters in diameter that are pathognomonic of infective endocarditis.[1] Pathologically, the lesion is described to be a microabscess of the dermis with marked necrosis and inflammatory infiltrate not involving the epidermis, which is due to the deposition of circulating immune complexes in small blood vessels.[1]

Overview

  • Janeway lesions are irregular, flat, painless, erythematous macules found on the palms, soles, thenar and hypothenar eminences of the fingertips, hands and plantar surfaces of the toes.

Etymology

They are named after Edward G. Janeway (1841–1911), a professor of medicine with interests in cardiology and infectious disease.[2]

Diagnosis

(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)


History and Symptoms

  • IV drug abuse
  • Infective endocarditis
  • Structural heart disease
  • Heart valve injury/replacement
  • Family history of autoimmune disorders
  • HIV status
  • Mucosal bleeding
  • Head/neck or lung infection
  • Tick exposure
  • Constitutional symptoms

Laboratory Findings

Chest X Ray

Echocardiography or Ultrasound

Other Diagnostic Studies

Differential Diagnosis

In alphabetical order. [3] [4]

Acute Pharmacotherapies

  • IV antibiotics
  • Antibiotic prophylaxis
  • Treat all underlying etiologies

Chronic Pharmacotherapies

Surgery and Device Based Therapy

  • Valve replacement for bacterial endocarditis

Indications for Surgery

References

  1. 1.0 1.1 Farrior, J.B. (1976). "A consideration of the differences between a Janeway's lesion and an Osler's node in infectious endocarditis". Chest. 70 (2): 239–43. doi:10.1378/chest.70.2.239. PMID 947688. Unknown parameter |coauthors= ignored (help)
  2. Janeway C. (1998). "Presidential Address to The American Association of Immunologists. The road less traveled by: the role of innate immunity in the adaptive immune response". J. Immunol. 161 (2): 539–44. PMID 9670925.
  3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  4. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

See also

Template:Eponymous medical signs for circulatory and respiratory systems


Template:WikiDoc Sources