Benign splinter hemorrhages.
Benign splinter hemorrhages.
A splinter hemorrhage (SH) is a small area of bleeding under the nail, appearing as a thin, red or brown streak usually along the distal end of the nail. The vast majority of SHs are benign. They may be precipitated by trauma. Only rarely are splinter hemorrhages associated with septic emboli and endocarditis.
Splinter hemorrhages are formed by the extravasation of blood from the nail bed´s longitudinal vessels. These hemorrhages are more common in fingernails than toenails and present as black, brown, or purple in color. The blood attaches to the underlying nail plate and moves distally as the nail continues to grow. It is most commonly caused by trauma.
Other potential causes of SH include systemic illnesses (ie, bacterial endocarditis or diabetes), cutaneous diseases (ie, psoriasis, onychomycosis, Darier disease, or Behcet), or drugs (ie, antibiotics, sedatives, tyrosine kinase inhibitors) or epidermal growth factor receptor inhibitors.
No treatment is needed. The SH grows out as the nail grows and is eventually shed.
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