Which statement correctly pairs an endocarditis sign with its description?

Which statement correctly pairs an endocarditis sign with its description?

• A. Splinter hemorrhages under nails — painless macules on palms and soles
• B. Osler nodes — painless macules on palms
• C. Janeway lesions — painless erythematous macules on palms and soles
• D. Roth spots — venous dilation of retina

Answer: (C)

In endocarditis, the skin and eye findings come from two different processes: septic emboli causing skin lesions and immune complex–driven lesions. Janeway lesions are the classic painless, erythematous macules on the palms and soles, produced by microemboli from infected valves. This description fits the pairing perfectly because it highlights the painless, vascular surface lesions on the hands and feet. Osler nodes, by contrast, are painful nodules on the fingertips or toes due to immune complex deposition. Splinter hemorrhages are tiny lines under the nails, not macules on the palms and soles. Roth spots are retinal hemorrhages with pale centers seen in the retina, not simply venous dilation. So the statement that Janeway lesions are painless erythematous macules on the palms and soles correctly pairs the sign with its description.

In endocarditis, the skin and eye findings come from two different processes: septic emboli causing skin lesions and immune complex–driven lesions. Janeway lesions are the classic painless, erythematous macules on the palms and soles, produced by microemboli from infected valves. This description fits the pairing perfectly because it highlights the painless, vascular surface lesions on the hands and feet.

Osler nodes, by contrast, are painful nodules on the fingertips or toes due to immune complex deposition. Splinter hemorrhages are tiny lines under the nails, not macules on the palms and soles. Roth spots are retinal hemorrhages with pale centers seen in the retina, not simply venous dilation.

So the statement that Janeway lesions are painless erythematous macules on the palms and soles correctly pairs the sign with its description.