Causes and risk factors
Janeway lesions are particularly seen in patients suffering from acute endocarditis, typically the bacterial one which is caused by Staphylococcus aureus. Septic emboli can also cause this lesion. The exact pathogenesis in the formation of these nodes is not known. However, certain theories have been put forth. One of the theories proposes that it is the result of a septic microemboli which arises from the endocardium.
Clinical presentation:
Janeway lesions are typically seen on the palm and sole. The thenar and hypothenar areas are also commonly affected. There is formation of bumps which are reddish purple in color. They are nontender and no pain occurs, however, bleeding is often seen. These nodes last for several days to weeks. Along with these, the patient often has other systemic complaints due to endocarditis.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the patient and an examination is carried out by the doctor. There is a history of endocarditis. Clinical examination of the lesion along with subjective complaint is often sufficient for the diagnosis. However, if required the doctor can advise investigations like routine and specialized blood test, urine test, blood cultures, chest x-ray, ECG, etc. Skin biopsy can also be done.
Treatment:
As Janeway lesions are caused due to endocarditis, treating the underlying cause is the main line of treatment. The lesion heals up eventually. For treating endocarditis, appropriate medications are started. If required, in severe cases, surgical intervention is suggested.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the disease. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating with the complaints of Janeway lesions.
