Janeway Lesion
Janeway lesions are non-tender, small erythematous or haemorrhagic macular or nodular lesions on the palms or soles only a few millimeters in diameter that are pathognomonic of infective endocarditis. Pathologically, the lesion is described to be a microabscess of the dermis with marked necrosis and inflammatory infiltrate not involving the epidermis. They are caused by septic emboli which deposit bacteria, forming microabscesses. Janeway lesions are distal, flat, ecchymotic, and painless.
Osler's nodes and Janeway lesions are similar, but Osler's nodes present with tenderness and are of immunologic origin.
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