1
|
Liang Y, Liang J, Huang Q, Tian X, Shao L, Xia M, Liu Y. Knuckle Pads Successfully Treated with 2% Crisaborole Ointment Combined with Triamcinolone Acetonide and Neomycin Plaster: A Case Report. Clin Cosmet Investig Dermatol 2023; 16:1893-1897. [PMID: 37519943 PMCID: PMC10378600 DOI: 10.2147/ccid.s414268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/16/2023] [Indexed: 08/01/2023]
Abstract
Knuckle pads (KPs) are benign hyperkeratotic fibrous thickening skin disorder characterized by nodules or plaques located on the extensor surface of the joints. However, there are no specific treatments for KPs so far. Here, we reported a case of KPs successfully treated with 2% crisaborole ointment combined with triamcinolone acetonide and neomycin plaster. This combined therapy might be a new therapeutic option for KPs.
Collapse
Affiliation(s)
- Yimin Liang
- Institute of Dermatology, Guangzhou Medical University, Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, People’s Republic of China
| | - Jingyao Liang
- Institute of Dermatology, Guangzhou Medical University, Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, People’s Republic of China
| | - Qiongxiao Huang
- Institute of Dermatology, Guangzhou Medical University, Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, People’s Republic of China
| | - Xin Tian
- Institute of Dermatology, Guangzhou Medical University, Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, People’s Republic of China
| | - Lei Shao
- Institute of Dermatology, Guangzhou Medical University, Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, People’s Republic of China
| | - Manqi Xia
- Institute of Dermatology, Guangzhou Medical University, Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, People’s Republic of China
| | - Yumei Liu
- Institute of Dermatology, Guangzhou Medical University, Department of Dermatology, Guangzhou Institute of Dermatology, Guangzhou, People’s Republic of China
| |
Collapse
|
2
|
Chandler Z, Seamon K, Ramsubeik K, Kaeley G. A case of knuckle pad syndrome in a middle-aged man. Clin Case Rep 2022; 10:e6740. [PMID: 36545555 PMCID: PMC9764040 DOI: 10.1002/ccr3.6740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/10/2022] [Accepted: 11/02/2022] [Indexed: 12/24/2022] Open
Abstract
Knuckle pads are benign papules, nodules, or plaques overlying joints and typically manifest at the proximal interphalangeal joints (PIPs). They may be confused with other dermatologic or rheumatologic diseases. Treatment options for primary knuckle pads are limited and acquired knuckle pads typically improve with withdrawal of the offending insult.
Collapse
Affiliation(s)
- Zachary Chandler
- Division of General Medicine, Department of MedicineUF COM – JacksonvilleJacksonvilleFloridaUSA
| | - Kimberly Seamon
- Division of General Medicine, Department of MedicineUF COM – JacksonvilleJacksonvilleFloridaUSA
| | - Karishma Ramsubeik
- Division of Rheumatology and Clinical Immunology, Department of MedicineUF COM – JacksonvilleJacksonvilleFloridaUSA
| | - Gurjit Kaeley
- Division of Rheumatology and Clinical Immunology, Department of MedicineUF COM – JacksonvilleJacksonvilleFloridaUSA
| |
Collapse
|
3
|
Adya KA, Inamadar AC, Palit A, Shivanna R. Knuckle lesions in inherited and acquired disorders. Indian Dermatol Online J 2021; 12:805-819. [PMID: 34934715 PMCID: PMC8653727 DOI: 10.4103/idoj.idoj_416_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 07/05/2021] [Accepted: 07/29/2021] [Indexed: 11/04/2022] Open
Abstract
Skin lesions occurring over the knuckles can be a primary or characteristic manifestation of a disorder. Characteristic knuckle lesions may also be important cutaneous features of various internal disorders when they serve as useful clinical pointers, as well as may speak of the disease severity in certain instances. Furthermore, knuckle lesions also speak of various external factors as the underlying cause of the disease/lesions, such as trauma - occupational or otherwise, and contact dermatitis. Although knuckles essentially imply dorsal aspect of the metacarpophalangeal joints, many of the lesions described as those 'involving the knuckles' are seen over the proximal and/or less frequently, the distal interphalangel joints as well. This review presents a compilation of various inherited and acquired dermatoses and dermatological manifestations of various internal disorders associated with different forms of knuckle lesions.
Collapse
Affiliation(s)
- Keshavmurthy A Adya
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Center, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Arun C Inamadar
- Department of Dermatology, Venereology and Leprosy, Shri B. M. Patil Medical College, Hospital and Research Center, BLDE (Deemed to be University), Vijayapur, Karnataka, India
| | - Aparna Palit
- Department of Dermatology, Venereology and Leprosy, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Ragunatha Shivanna
- Department of Dermatology, Venereology and Leprosy, ESIC Medical College and PGIMSR, Rajaji Nagar, Bengaluru, Karnataka, India
| |
Collapse
|
4
|
Sogliani D, Mura C, Tamborrini G. Successful treatment of idiopathic knuckle pads with a combination of high-dose salicylic acid and urea topical keratolytics: A case report. Dermatol Reports 2021; 13:9072. [PMID: 34040706 PMCID: PMC8139120 DOI: 10.4081/dr.2021.9072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/11/2021] [Indexed: 11/23/2022] Open
Abstract
Knuckle pads are benign subcutaneous and usually hyperkeratotic fibromas for which no specific treatments exist. Unspecific treatments are, most of the time, ineffective and a wait-and-see policy is often recommended to patients. However, especially in adolescents, knuckle pads are often poorly tolerated for cosmetic reasons, potentially causing embarrassment and social anxiety. Here we present the case of a young adult successfully treated with a combination of high-dose salicylic acid and urea topical keratolytics. In addition, we provide ideal diagnostic images obtained via high-resolution ultrasonography and histological features that can be used by medical practitioners to better distinguish knuckle pads from other proximal interphalangeal/ metacarpophalangeal joint diseases as also from other diseases inducing swelling of periarticular soft tissues.
Collapse
Affiliation(s)
- Davide Sogliani
- Department of Biology and Biotechnology, University of Pavia, Italy
| | - Chiara Mura
- Department of Biology and Biotechnology, University of Pavia, Italy
| | | |
Collapse
|
5
|
Tamborrini G, Köhler V, Kluge S. [CME Sonography 90: Tumors and Nodules of the Hand]. PRAXIS 2020; 109:367-381. [PMID: 32233764 DOI: 10.1024/1661-8157/a003435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
CME Sonography 90: Tumors and Nodules of the Hand Abstract. In this CME, which focuses on ultrasound of the musculoskeletal system, we concentrate on tumors and nodules on the hand and fingers. Firstly, the main focus is on device adjustment and image quality optimization. Second, individual tumors and nodules are discussed clinically and sonographically. Here we divide the tumors and nodules according to their anatomical localization: skin and subcutaneous tissue, muscles and tendons, nerves, vessels, bones and joints.
Collapse
|
6
|
Carloni R, Gandolfi S, Elbaz B, Bonmarchand A, Beccari R, Auquit-Auckbur I. Dorsal Dupuytren's disease: a systematic review of published cases and treatment options. J Hand Surg Eur Vol 2019; 44:963-971. [PMID: 31184950 DOI: 10.1177/1753193419852171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Dorsal lesions in Dupuytren's disease are rare and data concerning their epidemiology and management are sparse. We conducted a systematic review to summarize reported cases of dorsal Dupuytren's disease. Pubmed, Cochrane, and Embase databases were searched from 1893 to 2018, and 17 articles were selected (525 patients). The male to female ratio was 3.8:1. The dorsal disease was bilateral in 225 patients (50%). The index was the most commonly affected finger (48 patients). The proximal interphalangeal joint was the most commonly affected (484 cases). The most frequently reported lesions were knuckle pads (503 patients), dorsal nodules between interphalangeal joints (14 patients), boutonnière deformities (12 patients), and swan-neck deformities (2 patients). Nearly half of the included patients were treated surgically. Postoperative functional result depended on the treated lesion. Most of the included studies had a low level of evidence. Higher-quality studies are necessary to confirm our findings.
Collapse
Affiliation(s)
| | - Silvia Gandolfi
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Benedicte Elbaz
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Albane Bonmarchand
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Roberto Beccari
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Isabelle Auquit-Auckbur
- Department of Plastic, Reconstructive and Hand Surgery, Charles Nicolle University Hospital, Rouen, France
| |
Collapse
|
7
|
Hasbún C, Sandoval M, Curi M. A novel treatment for idiopathic knuckle pads with cantharidin-podophylotoxin-salicylic acid. Pediatr Dermatol 2019; 36:544-545. [PMID: 30883856 DOI: 10.1111/pde.13803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Knuckle pads are benign subcutaneous nodules that appear most frequently on the small joints of the hands. In children, they are often idiopathic, and no universally effective treatment has been reported. We present the case of an adolescent successfully treated with a combination of topical cantharidin -podophylotoxin -salicylic acid.
Collapse
Affiliation(s)
- Catalina Hasbún
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Sandoval
- Department of Dermatology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maximiliano Curi
- Department of Dermatology, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
8
|
|