On other occasions, DMs are lesions that appear in the evolution of critical patients and are due to factors derived from the stay or intensive treatment. Lastly, DMs can accompany patients and must be taken into account in the comprehensive pathology management. Several factors must be considered when addressing DMs: on the one hand, the moment of appearance, morphology, location, and associated treatment and, on the other hand, aetiopathogenesis and classification of the cutaneous lesion. #Osler nodes skin#ĭMs can be classified into 4 groups: life-threatening DMs (uncommon but compromise the patient's life) DMs associated with systemic diseases where skin lesions accompany the pathology that requires admission to the intensive care unit (ICU) DMs secondary to the management of the critical patient that considers the cutaneous manifestations that appear in the evolution mainly of infectious or allergic origin and DMs previously present in the patient and unrelated to the critical process. This review provides a characterization of DMs in ICU patients to establish a better identification and classification and to understand their interrelation with critical illnesses.Ī 70-year-old woman presented with a 9-day history of fever and appetite loss (both of which were of unknown etiology), unresponsive to antibiotics and fluids. The patient had a history of diabetes and hypertension, and had undergone ureteral stenting for obstructive pyelonephritis 2 months earlier. The patient was alert but lethargic her temperature was 38.6℃ and her pulse was 101 beats/min. On physical examination, peripheral signs were noted, including petechiae, Osler’s nodes, splinter hemorrhages, and Janeway lesions (Figure), suggestive of infective endocarditis,1 although no murmur was heard on cardiac auscultation.
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