Splinter hemorrhages were noted in a healthy 27-year-old man who presented with diffuse xerosis and scattered lichenified patches consistent with atopic dermatitis, without evidence of psoriasis. After treatment for impetiginized eczema with dicloxacillin and topical steroids, his skin quickly cleared except for scaling and fissuring of distal digits and slightly thickened nail plates with distal splinter hemorrhages. After ciclopirox olamine was administered topically for culture-proven Candida, his nails were normal except for distal splinters, especially in the fingers used most strongly in his golf grip (Figure). For 18 months he had been golfing up to 8 hours daily.
Splinter hemorrhages are tiny dark streaks under the nail plate variably found in skin conditions including psoriasis (akin to an Auspitz sign), onychomycosis, and, rarely, eczema, as well as in systemic diseases and trauma. When located in the middle third of the nail plate, they are infrequently related to trauma and more
Ryan AM, Goldsmith LA. Golfer's Nails. Arch Dermatol. 1995;131(7):857-858. doi:10.1001/archderm.1995.01690190113033