Splinter hemorrhages

Splinter hemorrhages are small areas of bleeding (hemorrhage) under fingernails or toenails. They take the shape of straight lines and may be caused by damage to the blood vessels.

Splinter hemorrhages appear as narrow, red-to-reddish-brown hemorrhages beneath the nails. They run in the direction of nail growth and are named splinter hemorrhages because they look like a splinter beneath the fingernail. The hemorrhages may be caused by microscopic clots that damage the small capillaries under the nails.

Splinter hemorrhages are associated with endocarditis (infection of the heart valves) and may represent vessel damage from inflammation of the blood vessels (vasculitis) or microscopic clots that damage the small capillaries (microemboli).

• Trauma to the nail (most common cause)
• Subacute or acute bacterial endocarditis

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