splinter hemorrhage (flame-shaped splinter hemorrhage)

Introduction

Red or brown streaks in the nail*.

Etiology

• endocarditis
  • microemboli
• psoriasis
• lichen planus
• pityriasis rubra pilaris
• chronic renal failure
• autoimmune connective tissue disease
  • vasculitis
  • systemic lupus erythematosus
• trichinosis
• onychomycosis
• scurvy
• trauma (most common cause)

Pathology

• nail bed capillary injury
• generally arising in the midportion of the nail bed

Clinical manifestations

• red-brown short fine lines in the nail bed
• subungual linear pigmented streaks following the long axis of the nail

- color changes from purple to brown or black as they age.

* images

* flame-shaped splinter hemorrhages are also seen in the retina in patients with ischemic optic neuropathy.

More general terms

• nail disease
• sign/symptom