In this article, I’m going to discuss with you all about Osler Nodes. The points which I am going to cover are:
So, without wasting any time let’s start the discussion step by step.
Osler Nodes are a rare but well-known manifestation of Bacterial endocarditis in the skin. They are painful, red lesions that mostly develop on the feet and hands.
They are associated with several health conditions including gonorrhea, hemolytic anemia, infective endocarditis, and typhoid fever. In simple words, Osler Nodes are caused by immune complex deposition.
Some scientists believe that the Osler’s nodes are found at the tip of the finger, the palm and the tip of the toes. They are also characterized by a lot of pain and discomfort.
Osler Nodes and Janeway are known to bring about similar signs and symptoms and are the manifestation of Infective Endocarditis. The lesions associated with Janeway are uncommon and are not as painful as the ones associated with Osler’s node. In addition, there is much confusion about their pathophysiology.
How Osler Nodes Got The Name?
William Osler was the mastermind behind the knowledge of Osler Nodes. His contribution to the understanding and knowledge behind Osler Nodes is known to be the most important of all times. This disease was fatal a few decades ago but the proper understanding and knowledge by Willia Osler have made it curable and this is how they got their name.
William Osler’s contributions to understanding the condition turned out to be quite helpful. Nowadays, the condition is curable and there are fewer problems associated with it.
I am going to discuss with you 3 main causes of Osler Nodes.
- Infective Endocarditis
- Gonococcal Infection
- Subacute Cutaneous Lupus Erythematosus
Let’s discuss them in detail.
1. Infective Endocarditis (IE)
This condition is caused by the infection of the inner surface of the heart. In most cases, it is the infection of the valves. The complications may include heart failure, stroke, valve insufficiency, and kidney failure.
The 3 Bacteria, Staphylococcus aureus, streptococci, and the negative staphylococci are the main causes of IE which were initially described by William Osler.
The condition may present a wide collection of clinical signs and symptoms. However, in most cases, the signs can be misleading or sometimes difficult to detect. Some of the clinical signs are common. The presence of endocarditis may lead to a valvular dysfunction.
One of the most common endocarditis sign is Osler’s nodes. The conditions created in the heart may reflect directly to a common skin disease. It can also lead to Janeway lesions, splinter hemorrhages, and clubbing. (1)
2. Gonococcal Infection
This is a sexually transmitted bacteria that can be fatal if not treated. It is a very common disease among people who are sexually active without precautions.
According to a report of 2015, in the US only, there are over 820,000 new N. gonorrhoeae infections that are counted every year. (2)
It is known as the second most common bacterial sexually transmitted disease (STD). The symptoms brought by the infection lead to swelling, redness and in some other cases pain that characterize the lesions.
3. Subacute Cutaneous Lupus Erythematosus
It is a type of lupus erythematosus which has distinct characteristics. (3)
If the infection is present, one of the most common sign is the Osler’s nodes. Although old men and women could also get infected with it, it is most common among young and middle-aged people.
Symptoms of Osler Nodes
Osler’s nodes are similar to the Janeway Lesions and therefore, many people have difficulties differentiating them without a histological examination.
But, here I am going to tell you some of the most prominent and common symptoms of Osler Nodes so you can differentiate it with Janeway Lesions.
- Reddish brown nodules on your skin (palms, hands, feet, toes)
- Pain on the nodules
- Slightly Raised Nodules with Pale surface
Along with the above description, see the following pictures also for better understanding.
Osler’s Nodes Treatment
According to medical experts, Osler’s nodes take between 7 hours to few days to settle down. But this does not mean that you don’t need any treatment. If it is not treated, they can reoccur and cause more damage to the skin than before.
If they appear due to infective causes, then they should be treated early enough to avoid further progression. Although they can go away on their own, if your immune system is weak, then anti-allergic drugs must be taken to reduce the hypersensitivity of the immune system.
Infective Endocarditis could be difficult to diagnose due to the presence of various features. Antibiotics are the main source of treating IE. In the case of acute IE, antibiotic therapy must be taken early enough to minimize Valvular damage.
Those who have a history of Intravenous drug use can be treated using gentamicin and nafcillin, which should cover the methicillin-sensitive staphylococci.
With the rise of some serious and more difficult to treat streptococci such as Methicillin-resistant Streptococci and penicillin-resistant S aureus medical field has also changed the tactics of treatment.
In short, if you see the signs of Osler Nodes (mentioned above) start the treatment process immediately. If it is not treated well and on time, the consequences could be very bad.