Nail Signs Splinter Haemorrhages 指甲裂片形出血

Splinter Haemorrhages appear as one or more red–brown to purple–black, thin longitudinal lines in the distal portion of the nail. The shape of the subungual hemorrhages is due to the longitudinal orientation of nail bed capillaries. The most common cause of splinter hemorrhages is trauma, followed by psoriasis, onychomycosis, and occasionally medications. Proximal splinters are rare and possible indicators of systemic diseases, including endocarditis (infectious and marantic), vasculitis (including septic vasculitis), trichinosis, and the antiphospholipid antibody syndrome.

Approximately 30% of patients with tuberous sclerosis complex have “red comets”, i.e. short red longitudinal streaks of the nail with an enlarged distal end. They are partially blanchable and are thought to represent telangiectasias plus extravasated blood.

Splinter1

指甲裂片形出血是在指甲的远端部分显示为一条或多条红褐色至紫黑色，细长的纵向线。甲下出血的形状是由于甲床毛细血管的纵向取向。甲分裂出血的最常见原因是创伤，其次是牛皮癣，甲癣和偶尔的药物治疗。近端碎片是罕见的并且可能是全身性疾病的指标，包括心内膜炎（传染性和消耗性），血管炎（包括脓毒性血管炎），旋毛虫病和抗磷脂抗体综合征。大约30％的结节性硬化症患者具有“红色彗星状出血”，即短的红色纵向条纹的指甲向远端扩大。

Reference:

 

  1. Antonella Tosti, Bianca Maria Piraccini. In: Jean Bolognia Julie Schaffer Lorenzo Cerroni, editors. Dermatology: 2-Volume Set 4th Edition. Elsevier; 2017. p1204-1205.
  2. CS Aldrich, Hong CH, L Groves, et al.: Acral lesions in tuberous sclerosis complex: insights into pathogenesis. J Am Acad Dermatol. 63:244-251 2010
  3. Calvert HT, Smith MA, Wells RS. Psoriasis and the nails. Br J Dermatol 1963;75:415–18.