Splinter hemorrhages

Splinter hemorrhages (or haemorrhages) are tiny lines that run vertically under nails. Splinter hemorrhage is a nonspecific finding and can be associated with subacute bacterial endocarditis, scleroderma, trichinosis, Systemic lupus erythematosus (SLE), rheumatoid arthritis, psoriatic nails and trauma.

At first they are usually plum-colored, but then darken to brown or black in a couple of days. In certain conditions (in particular, infective endocarditis), clots can migrate from the affected heart valve and find their way into various parts of the body. If this happens in the finger, it can cause damage to the capillaries resulting in a splinter hemorrhage.

There are a number of other causes for splinter hemorrhages. They could be due to hitting the nail (" trauma"), a sign of inflammation in blood vessels all around the body ("systemic vasculitis"), or they could be where a bit of cholesterol has got lodged in the finger's capillaries. Even if a patient does have infective endocarditis, probably 5 in every 6 patients won't have splinter hemorrhages.

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