Rheumatoid Arthritis
Splinter hemorrhage is caused by rheumatoid arthritis when the disease affects the blood vessels, either by inflammation or constriction. When the blood vessels are affected in the hand and fingers, they can no longer deliver enough blood to the tissues. As a result, the tissues become starved of blood and die. This can lead to a splinter hemorrhage, which looks like a small blotch of blood under the skin. First-degree splinter hemorrhages are very common, but second and third-degree ones are rare.
The most common distribution for splinter hemorrhages is over the knuckles on the back of the hand, with many small blood vessels close to the surface. People with rheumatoid arthritis sometimes complain that their fingers look bruised or bloody for no apparent reason.
Sometimes splinter hemorrhages will appear after an injury since trauma may cause extra bleeding into a tissue already damaged by rheumatoid arthritis. Splinter hemorrhages may occur anywhere on the hands and fingers where small blood vessels are close to the surface. The wrists and backs of hands can also be affected by splinter hemorrhages if there is enough rheumatoid arthritis damage in those areas.
