Medical Emergencies · single question
Janeway lesions and Osler nodes on the hands and feet are peripheral signs of which condition?
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Correct answer: B. Infective endocarditis
- A. Incorrect. SLE produces a malar 'butterfly' rash and a photosensitive discoid rash; oral ulcers are also a diagnostic criterion.
- B. Correct. Both are classic peripheral stigmata of INFECTIVE ENDOCARDITIS. JANEWAY LESIONS are non-tender haemorrhagic macules on the palms and soles (septic microemboli). OSLER NODES are painful, tender nodules on the finger and toe pulps (immune complex deposition). Remember: 'Osler = Ouch.' Other signs are splinter haemorrhages and Roth spots in the retina.
- C. Incorrect. Kawasaki disease causes erythema and desquamation of the palms and soles in a child with prolonged fever, plus 'strawberry tongue' and conjunctivitis — but not Janeway lesions or Osler nodes.
- D. Incorrect. Rheumatic fever's cutaneous features are erythema marginatum (a serpiginous rash on the trunk) and subcutaneous nodules over extensor surfaces — not palmar/plantar lesions.
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