Knuckle pads

Knuckle pads

Cause

Sometimes these are familial; usually they are not.

Trauma seems not to be important.

Presentation

Fibromatous and hyperkeratotic areas appear on the backs of many finger joints, usually beginning in late childhood and persisting thereafter. There may be an association with Dupuytren’s contracture.

Differential diagnosis

Occupational callosities, granuloma annulare and viral warts should be considered.

Investigations

A biopsy may be helpful in the few cases of genuine clinical difficulty.

Treatment

None, including surgery, is satisfactory.