What Causes Splinter Hemorrhage & How Is It Treated?

What is Splinter Hemorrhage?

Splinter Hemorrhage is referred to an abnormality seen in the fingernails. The condition gets its name due to its resemblance with a splinter below the nails and the red tinge that it has. Due to a Splinter Hemorrhage, the fingers nails will have vertical streaks down the nails appearing as miniature blood vessels. The flexibility and strength of a fingernail is derived from keratin, which is a protein found in the body. The nails grow from a part of the nail called the matrix. This is the part that produces cells of keratin. These cells then form one layer over another and grow. Once the nails grow out, they consist of only dead keratin cells. These are the nails which are clipped with a nail cutter every so often without any pain or discomfort.[1]

What is Splinter Hemorrhage?

Splinter Hemorrhage in some cases indicates an underlying medical condition but these instances are quite low. Mostly, Splinter Hemorrhages are harmless and pose no threat to the overall health of a person. Read below to know the causes and treatment options for Splinter Hemorrhages.[1]

What Causes Splinter Hemorrhage?

Splinter hemorrhages are caused due to leaking of blood from the vessels present in the nailbed. Another cause for Splinter Hemorrhage is the presence of small blood clots, also known as microemboli, in the capillaries. However, the most common cause of Splinter Hemorrhage is believed to be trauma to the nails and constitute for about 20% of cases of Splinter Hemorrhage. A nail trauma can be caused due to objects dropping on the nails or hitting the nails against furniture or a door.[1]

If none of these are believed to be causing the condition, then Splinter Hemorrhage is an indicator of an underlying medical condition. Some of the medical conditions that cause Splinter Hemorrhage include:[1]

Antiphospholipid Syndrome: This is a medical condition in which blood clots develop in the arteries and veins. This can be as a result of lupus but sometimes this occurs without any known cause.[1]

Infectious Endocarditis: This condition is caused due to a bacterial or fungal infection affecting the tissues of the heart. The most common cause of Infectious Endocarditis is the strep bacterium. This bacterium can bypass the immune system and infiltrate the heart especially in cases where a person has a damaged heart valve or has a dysfunctional heart. IV drug abusers are also at risk for having Infectious Endocarditis. Splinter Hemorrhage is one of the presenting features of Infectious Endocarditis.[1]

Nail Psoriasis: It is an autoimmune condition in which there is accumulation of excess cells on the nails. This causes a vertical streak to form on the nails indicative of Splinter Hemorrhage. In some cases, the nails may even separate from the nailbed.[1]

Systemic Lupus Erythematosus: This is again an autoimmune condition which apart from Splinter Hemorrhage causes joint pain, clots, and circulation problems in the fingers.[1]

There have been rare instances of certain medications causing an individual to have Splinter Hemorrhage. These medications include aspirin, Coumadin, and Cytovene which is a drug used for chemotherapy.[1]

How is Splinter Hemorrhage Treated?

Coming to the treatments of Splinter Hemorrhage, the cause determines the course of action. If trauma is believe to be causing Splinter Hemorrhage, then no treatment is required and the condition resolves within a few months as the nails continue to grow. It is also advisable to make the nails strong and prevent Splinter Hemorrhage by eating a diet rich in vitamin B and zinc and staying hydrated.[1]

However, in cases where Splinter Hemorrhage is caused due to an underlying medical condition then it will warrant treatment depending on the type of illness the individual has. If medications are believed to be causing Splinter Hemorrhage then a consultation with the physician is recommended to adjust the medication or change it.[1]

In case if Splinter Hemorrhage is accompanied by symptoms like fever, petechiae, or joint pain then immediate consultation should be sought to rule out something serious going on. Consultation should also be sought if it is observed that the Splinter Hemorrhage themselves are painful.[1]

In conclusion, Splinter Hemorrhage is a harmless condition that alters the way the fingernail looks. There will be a clear observable vertical streak going down the fingernail in people with Splinter Hemorrhage. Trauma and injury to the nail is the primary cause of this condition. However, in some cases Splinter Hemorrhage is caused due to an underlying medical condition or due to taking some medications, in such cases, it is best to consult with a physician.[1]

Depending on the type of the condition, the physician will formulate a treatment plan best suited for the patient. In cases of medications causing Splinter Hemorrhage, either changing the medication or stopping it completely is some of the ways to treat the condition. This should however be done at the discretion of the treating physician.[1]

Additionally, it is also important for an individual with Splinter Hemorrhage to consult with a physician if there is no immediate cause identified that could have caused the condition.[1]

References:

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