splinter haemorrhage
splinter haemorrhage
A small, linear subungual haemorrhage, which is red when fresh and brown when aged, located at the distal 1/3 of the nailbed and classically associated with mitral stenosis.Pathogenesis
The blood “leaks” into the avascular squames under the fingernails due to microemboli and/or increased capillary fragility. While splinter haemorrhages (SHs) are characteristic of acute and subacute bacterial endocarditis, they are more commonly due to trauma, occurring in up to 10% of normal subjects and in 40% of patients with mitral stenosis; SHs also occur in the retina in papilledema, due to retinal vein occlusion, subarachnoid haemorrhage or, rarely, trichinosis.