https://doi.org/10.4081/reumatismo.2021.1354
Knuckle pads mimic early psoriatic arthritis
Submitted: 22 September 2020
Accepted: 23 February 2021
Published: 19 April 2021
Accepted: 23 February 2021
Abstract Views: 10032
PDF: 728
Publisher's note
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Knuckle pads or Garrod’s nodes are a rare, non-inflammatory condition. They consist of benign, well-circumscribed fibro-adipose tissue over the small joints of hands and feet. Knuckle pads may be under-diagnosed and mistaken for early arthritis. The rheumatologist should perform an accurate differential diagnosis in which he can be helped by ultrasound and by other colleagues, such as the dermatologist. Ultrasound is considered useful in the assessment of the thickening of the subcutaneous tissue, located usually on the extensor site of proximal interphalangeal and metacarpophalangeal hand joints. Dermoscopy may play a role in detecting epidermal and dermal changes. We hereby report the case of a female patient with knuckle pads mimicking psoriatic arthritis.
Zabotti A, McGonagle DG, Giovannini I, et al. Transition phase towards psoriatic arthritis: clinical and ultrasonographic characterisation of psoriatic arthralgia. RMD Open. 2019; 5: e001067.
DOI: https://doi.org/10.1136/rmdopen-2019-001067
Nenoff P, Woitek G. Knuckle Pads [Internet]. Massachusetts Medical Society; 2011 [cited 2021 Jan 6]. Available from: https://www.nejm.org/doi/10.1056/NEJMicm1008915
Zabotti A, Errichetti E, Cereser L, et al. Pachydermodactyly: the role of ultrasonography and dermoscopy for diagnosis. Rheumatology. 2017; 56: 703-703.
DOI: https://doi.org/10.1093/rheumatology/kew378
Hyman CH, Cohen PR. Report of a family with idiopathic knuckle pads and review of idiopathic and disease-associated knuckle pads. Dermatol Online J 2013; 19: 18177.
DOI: https://doi.org/10.5070/D3195018177
Lopez-Ben R, Dehghanpisheh K, Chatham WW, et al. Ultrasound appearance of knuckle pads. Skeletal Radiol. 2006; 35: 823-7.
DOI: https://doi.org/10.1007/s00256-006-0110-8
Zabotti A, Piga M, Canzoni M, et al. Ultrasonography in psoriatic arthritis: which sites should we scan? Annals of the Rheumatic Diseases. 2018; 77: 1537-8.
DOI: https://doi.org/10.1136/annrheumdis-2018-213025
Savage L, Tinazzi I, Zabotti A, et al. Defining pre-clinical psoriatic arthritis in an integrated dermato-rheumatology environment. J Clin Med Multidis Digital Publ Inst. 2020; 9: 3262.
DOI: https://doi.org/10.3390/jcm9103262
Zabotti A, Errichetti E, Zuliani F, et al. Early psoriatic arthritis versus early seronegative rheumatoid arthritis: role of dermoscopy combined with ultrasonography for differential diagnosis. J Rheumatol. 2018; 45: 648-54.
DOI: https://doi.org/10.3899/jrheum.170962
Errichetti E, Zabotti A, Stinco G, et al. Dermoscopy of nail fold and elbow in the differential diagnosis of early psoriatic arthritis sine psoriasis and early rheumatoid arthritis. J Dermatol. 2016; 43: 1217-20.
DOI: https://doi.org/10.1111/1346-8138.13438
Kodama BF, Gentry RH, Fitzpatrick JE. Papules and plaques over the joint spaces. Knuckle pads (heloderma). Arch Dermatol. 1993; 129: 1044-5, 1047.
DOI: https://doi.org/10.1001/archderm.129.8.1044
Keersmaeker AD, Vanhoenacker F. Imaging Features of Knuckle Pads. J Belgian Soc Radiol. 2016; 100: 67.
DOI: https://doi.org/10.5334/jbr-btr.1096
Hasbún C, Sandoval M, Curi M. A novel treatment for idiopathic knuckle pads with cantharidin-podophylotoxin-salicylic acid. Pediatr Dermatol. 2019; 36: 544-5.
DOI: https://doi.org/10.1111/pde.13803
Weiss E. A novel treatment for knuckle pads with intralesional fluorouracil. Arch Dermatol. 2007; 143: 1447.
DOI: https://doi.org/10.1001/archderm.143.11.1458
How to Cite
Giovannini, I., Zandonella Callegher, S., Errichetti, E., De Vita, S., & Zabotti, A. (2021). Knuckle pads mimic early psoriatic arthritis. Reumatismo, 73(1), 67–69. https://doi.org/10.4081/reumatismo.2021.1354
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