Osler Node and Janeway Lesions

Excerpt

Osler nodes and Janeway lesions are cutaneous manifestations of endocarditis, a disease most commonly arising from a bacterial or fungal infection of the cardiac endocardium. Osler nodes are tender, purple-pink nodules with a pale center and an average diameter of 1 to 1.5 mm. They are generally found on the distal fingers and toes, though they can also present on the lateral digits, hypothenar, and thenar muscles. The pain usually proceeds nodule development, and they disappear in hours to days, leaving no sequelae. Janeway lesions are irregular, non-tender, erythematous, or hemorrhagic macules or papules commonly found on the palm and soles, lasting days to weeks. The presence of pain is conventionally a means to differentiate Osler nodes from Janeway lesions since accurate differentiation may be challenging, secondary to overlap in the appearance and histology of these two lesions.