Clinical Diagnosis ?
Janeway lesions
Janeway lesions are non-tender, erythematous (or haemorrhagic) macules in the palms or soles, and are pathognomonic of infective endocarditis. They appear as flat, painless, red to bluish-red spots on the palms and soles. On pathology, it may show evidence of suppuration and microabscesses without treatment. On appropriate therapy, it may show only inflammatory reaction.
Keep as reference an excellent article published in chest 30 years ago: Janeway's lesion and an Osler's node in - A consideration of the differences between a infectious endocarditis, Chest 1976;70;239-243 - pdf document
