Janeway lesions are best described as

Janeway lesions are best described as

• A. Painful nodules on fingertips.
• B. Linear streaks under nails.
• C. Painless erythematous macules on palms and soles associated with infective endocarditis.
• D. Immune complex deposition in joints.

Answer: (C)

Janeway lesions reflect a vascular manifestation of infective endocarditis. They are painless erythematous or hemorrhagic macules on the palms and soles that arise from septic microemboli shed by infected heart valve vegetations. Because they are caused by emboli lodging in small vessels and forming microabscesses, they are typically non-tender. This distinguishes them from Osler nodes, which are tender nodules on the fingertips caused by immune complex deposition. Splinter hemorrhages under the nails are another vascular finding in endocarditis, but they look different and are not the same lesion. The presence of painless palmar/plantar lesions in the right clinical context helps point toward infective endocarditis.

Janeway lesions reflect a vascular manifestation of infective endocarditis. They are painless erythematous or hemorrhagic macules on the palms and soles that arise from septic microemboli shed by infected heart valve vegetations. Because they are caused by emboli lodging in small vessels and forming microabscesses, they are typically non-tender. This distinguishes them from Osler nodes, which are tender nodules on the fingertips caused by immune complex deposition. Splinter hemorrhages under the nails are another vascular finding in endocarditis, but they look different and are not the same lesion. The presence of painless palmar/plantar lesions in the right clinical context helps point toward infective endocarditis.