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Osler's nodes Pictures, Definition, Symptoms, Causes, Treatment


Osler's nodes are small red tender nodules located in the fingertip and at the proximal end and the lateral edge of the nails. They grow over a period of several days to weeks. Janeway lesions are little different from from osler's nodes because they often appeared as non-tender hemorrhagic or nodular lesions on the palms and feet. Clinically both are cardinal manifestations of subacute bacterial endocarditis.

At the beginning of these nodes, patients might feel nerve pain or neurological pain. Although these nodes originally considered to be derived via immune system response. It is proposed that the microembolization along with micro-abscess is occurred due to vasculitis triggered by immunomodified hypersensitivity. Osler's nodes may appear at any time during subacute cutaneous lupus erythematosus and may take several hours to a few days to settle down. They may also be due to infective endocarditis.

Osler's nodes usually ranges from 0.5cm to 1cm and appear as painful brownish or reddish subcutaneous papules on feet, finger tips, toes and palms. Many researchers are still trying to find out exact underlying pathophysiology that triggers such kinds of nodes. However, current clinical data suggests that these nodes are occurred due to immune system hypersensitivity.

Osler's nodes Pictures

Osler's nodes Pictures, Definition, Symptoms, Causes, Treatment

Osler's nodes Pictures, Definition, Symptoms, Causes, Treatment

Osler's nodes Symptoms

Physically, osler's nodes are quite similar to janeway lesions so, it is difficult to differentiate them without examining further via microscopical or histological examination. However, some commonly observed features of osler's nodes during clinical practice are

  • Nodules like appearance at finger tips, palms, toes and feet
  • Reddish brown in color
  • Painful
  • Itching
  • Feeling of tenderness
  • Slightly raised with pale surface

Osler's nodes Causes

Exact etiological factors that drive the whole process are still not fully understood but many immunologist believe that infective endocarditis, subacute cutaneous lupus erythematosus and gonococcal infection are strongly associated with such kind of nodes and lesions. Hypersensitive immune system is another factor that triggers such phenomenon.

Osler's nodes Treatment

Osler's nodes usually last several hours to a few days to settle down. However, root cause treatment is necessary otherwise they might appear again at some point. If osler's nodes appear due to infective process then then primary problem should be treated accordingly to avoid further progression. Similarly, if immune system is main culprit then anti-allergic drugs should be used to reduce hypersensitivity of immune system.

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