What are Janeway lesions, also known as Infective Endocarditis (IE) lesions?

From the Guidelines

Janeway lesions are small, painless, flat, red or purple spots that appear on the palms of the hands and soles of the feet in patients with infective endocarditis, caused by septic emboli and considered a classic peripheral manifestation of the disease. These lesions are typically non-tender, measure 1-4 mm in diameter, and do not blanch when pressure is applied 1. They are often associated with Staphylococcus aureus infections and are distinct from Osler's nodes, another skin manifestation of endocarditis. The presence of Janeway lesions should prompt immediate evaluation for endocarditis, including blood cultures and echocardiography, as infective endocarditis requires prompt antibiotic treatment 1.

Key Characteristics of Janeway Lesions

• Small, painless, flat, red or purple spots
• Appear on the palms of the hands and soles of the feet
• Caused by septic emboli
• Non-tender
• Measure 1-4 mm in diameter
• Do not blanch when pressure is applied

Importance of Janeway Lesions in Infective Endocarditis

• Considered a classic peripheral manifestation of infective endocarditis
• Often associated with Staphylococcus aureus infections
• Distinct from Osler's nodes, another skin manifestation of endocarditis
• Presence of Janeway lesions should prompt immediate evaluation for endocarditis, including blood cultures and echocardiography 1

Diagnosis and Treatment of Infective Endocarditis

• Diagnosis is often imprecise, but can be made with positive blood cultures and/or characteristic echocardiographic findings 1
• Treatment requires prompt antibiotic therapy, which can lead to resolution of Janeway lesions and other symptoms of infective endocarditis 1

From the Research

Definition and Characteristics of Janeway Lesions

• Janeway lesions are also known as Infective Endocarditis (IE) lesions 2
• They are painless erythematous macules that usually affect palms and soles 2
• These lesions are a type of dermatological manifestation of infective endocarditis, which can be useful in the presumptive diagnosis of the disease 2

Comparison with Other Dermatological Manifestations

• Janeway lesions are distinct from Osler's nodes, which are painful, purple nodular lesions usually found on the tips of fingers and toes 2
• Both Janeway lesions and Osler's nodes can be indicative of infective endocarditis, highlighting the importance of skin examination in diagnosis 2

Infective Endocarditis

• Infective endocarditis is a rare, life-threatening disease that can have long-lasting effects even among patients who survive and are cured 3
• The diagnosis of IE may be difficult to establish and often requires a combination of clinical, microbiological, and echocardiography results 3