Janeway lesions are skin abnormalities associated with diseases like infective endocarditis and fungal aneurysm. They are small, painless, and often found on the palms and soles of the feet. They can help diagnose underlying systemic diseases and typically resolve on their own with treatment of the underlying condition.
A Janeway lesion is a skin abnormality associated with several diseases, including infective endocarditis and fungal aneurysm. The lesions are usually found on the palms and soles of the feet, are small in diameter, and are not painful. Typically, no treatment is required for these skin abnormalities, and they often resolve when the underlying disease that caused them is treated.
Diagnosing a Janeway lesion can usually be made based on its appearance. The lesions tend to be dark red or bright red in color. They may be flat, without being significantly raised off the skin surface, or they may be raised. In other cases, the lesions extend inferiorly into the underlying tissue of the skin and feel firm when touched. They are typically quite small in size, with each lesion having a diameter of a quarter of an inch or less, and the lesions often occur in clusters.
Patients typically have no pain associated with a Janeway lesion. Most often these skin abnormalities are found on the soles of the feet, palms of the hands, and fingertips. Occasionally the skin overlying the injury may erode, exposing the underlying tender tissue, causing pain and inflammation.
The most important reason a Janeway lesion is helpful to diagnose is that it can herald the presence of an underlying systemic disease. Most commonly, the lesions are associated with infective endocarditis, which is a condition that occurs when bacteria or other pathogens infect the valves of the heart. Janeway’s lesion could also indicate the presence of a rarer condition called mycotic aneurysm, which occurs when a dilation of one of the body’s large blood vessels becomes infected by certain bacterial species.
Finding a Janeway lesion on a patient can help doctors or health care providers diagnose infective endocarditis. In fact, it is one of the minor criteria that can be used to diagnose this condition, according to the generally accepted diagnostic criteria for the disease. It is considered one of the vascular phenomena associated with the disease, as it occurs due to inflammation of blood vessels in the body. If there are five minor criteria associated with infective endocarditis, or if three minor criteria and one major criterion are found, then the diagnosis can officially be made.
Very often, patients with a Janeway lesion are not treated for it. This is because the lesions usually resolve on their own as the underlying condition is treated. Patients who experience pain with the lesions might use ointments to soothe the irritation or they might use analgesic medications to relieve pain.
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