Splinter hemorrhages in Infective endocarditis??? - cancer_84

[ArchivalUser]

I am confused what is the origin of splinter hemorrhages in infective endocarditis?

Goljan said it was Type 3 hypersensitivity- vasculitis, he also said that back in time they used to think that these lesions were microembolies but this concept has been changed and now they think all these lesions are type 3 hypers vasculitis

UW world says they are microembolies originated from vulvar vegetations

can anyone clear this up?

[ArchivalUser]

Poppy was correct back then and nothing change 14 yrs ago he was talking about it in general in circulating complexes of Ab & bug Ag Type III back then. UW copy from his note "Splinter hemorrhages"-> subungual micro/emboli bz valve start peeling and complexes make path ready for landing. Nothing to be confuse of.

Q) SLE pat do u see splinter hemorrhages? if so, that's do to what Hyp Rxn?

[ArchivalUser]

thanks Cardio I reapply appreciate ur explanation

basically UW says same thing without calling it immune complex? is this right?

in SLE vegetations are fibrinoid necrosis and it is type 3... I am not sure if u see pointer hemorrhages, do not recall reading it

do u see splinter hemorrhages?

[ArchivalUser]

“Splinter Hemorrhage”/nail we are talking about as u ask on your post...

Capillary leak at epidermal ridge and no matter much pressure u apply the lines persist -> NON-blanchable apper under the nail plate. How it happen as u see it ? Occur in the dermis after rupture of the capillaries -> the linear configuration epidermal/dermal ridges-> blood from rupture drag-> or glue like traffic line to the nail plate -> moves distally as time pass and nail grow -> resembling wood “Splinter Hemorrhage” and yes if the hemorrhage spots remain stationary if attached to the nail BED & NOT nail plate. One thing you may what to know anything really ass w many problem the classic u just know CLASSIC form from poppy is IE however MC local traumas but can asso many condition pulmonary/edocr/ renal OR ; eczema, vasculitis, onychomycosis, psoriasis ( u recall where nail plate dystrophy-> capillary become fragile similar to Auspitz sign), or in your ddx you always conclude SLE, RA, peptic, scleroderma antiphospholipid synd, dermatomyositis, telangiectasias, hyperkeratotic ragged cuticles, red lunula OR even drugs oral contraceptive ( or even pregnancy ) Vit c/scurvy, warfarin, aspirin, chemo (eg taxanes), tetracycline, ganciclovir……. We can go on… & on… that cause similar appearing lesions
And one more that I just post in my q in forum I will add it after ppl get rt… however no one could ans yet. Try it http://www.usmleforum.com/showthread.php?tid=792537

[ArchivalUser]

Well, Splinter Hemorrhage is defined as an issue that happens to your fingernails as well as toenails. This Splinter Hemorrhage is just a tiny blood spots that used to appear underneath the toenails. This issue used to look like splinters and take place when tiny blood vessels become damaged toenail bed and even burst. The toenail bed is referred to the skin underneath the toenail. However, there are different treatments available for splinter hemorrhage. You can look for them also and try to get rid of this issue as soon as possible. Know more at:

http://www.curetoenailfungus.info/blog/a...mpaign=frm