Definition

Splinter hemorrhages are small areas of bleeding or hemorrhage under fingernails or toenails. They take the shape of straight lines and may be caused by microembolic damage to the vessels.

Alternative Names

Fingernail hemorrhage

Considerations

Splinter hemorrhages appear as narrow red to reddish brown hemorrhages beneath the nails. They run in the direction of nail growth and are named splinter hemorrhage because they have the appearance of a splinter beneath the fingernail. The hemorrhages may be caused by microscopic clots that damage the small capillaries under the nails.

Splinter hemorrhages are associated with endocarditis and may represent vessel damage from inflammation of the blood vessels (vasculitis) or microscopic clots that damage the small capillaries (microemboli).

Causes

• Trauma to the nail (most common cause)
• Subacute or acute bacterial endocarditis

Review Date: 2/12/2004
Reviewed By: Sreeni Jonnalagadda, M.D., Interventional and Pancreatobiliary Endoscopy, Washington University School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network.