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Splinter hemorrhages are commonly seen in conditions such as nail psoriasis and lichen planus Dermal vascular dilatation and tortuosity from psoriasis can lead to splinter hemorrhages. Nail psoriasis is an autoimmune disorder that causes skin cells to collect on your nails.

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What is a splinter haemorrhage Splinter hemorrhages are more commonly associated with nail psoriasis, but can also occur with eczema, vasculitis, or onychomycosis 7 Nail bed psoriasis manifests as onycholysis, oil drops (or salmon patches), dyschromia, splinter hemorrhages, and subungual hyperkeratosis

Onycholysis is separation of the nail plate from the underlying nail bed.

They are accentuated, parallel, elevated ridges in the nail surface that occur with aging or in association with alopecia areata, vitiligo, atopic dermatitis, or psoriasis. Splinter hemorrhages are a common feature of nail psoriasis In a systematic review including 11 studies and 723 cases of nail psoriasis, splinter hemorrhages were reported in 54% of cases (n = 408) [9]. Farber11 described subungual splinter hemorrhages as a characteristic finding in nail psoriasis, perhaps analogous to the auspitz sign (i.e., multiple fine bleeding points when a scale is removed from a psoriatic plaque, caused by thinning of the epidermis over the dermal papillae).

Nail involvement in psoriasis is common It is seen in 80% of cases and may be the only manifestation in only 6% [1,2] It includes onycholysis, pitting, subungual hyperkeratosis, red lunula, oil spots (salmon patch), nail dystrophy, leukonychia, and splinter hemorrhages [3]. Small hemorrhages under the nail bed, known as splinter hemorrhages, can be caused by trauma or may indicate underlying health issues like psoriasis or heart conditions.

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Splinter hemorrhages are usually localized in the distal nail and are commonly seen in inflammatory diseases, including eczema (chapter 446), psoriasis (chapter 446), and onychomycosis.

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