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Knuckle Pads in Dupuytren's Contracture

March 24, 2020

Also called 'Heloderma', knuckle pads can be defined as “keratotic, circumscribed, fibrous growths over the dorsal of the interphalangeal joints.”


The condition is described as plaque-like, round, fibrous, well-defined thickening that may begin to develop at any age. It can grow to be 1 to 15mm in diameter.


It usually takes a few months to worsen and may disappear over time.

There still isn’t much known about the situation as it’s still new but scientists have found a direct connection between knuckle pads and Dupuytren's Contracture.

Knuckle Pads and Dupuytren's Contracture

Some patients with Dupuytren's contracture may end up with localized hard areas under the skin dorsal to the finger joints. In some cases, these may be fixed to the underlying extensor mechanism or the skin. However, that is said to happen in rare cases. 


Most users have normal or thin skin but some may end up with wrinkled skin. Doctors tend to believe that patents with Dupuytren's contracture run a higher risk of having knuckle pads, which is why it is also often referred to as dorsal Dupuytren nodules.


This makes it easier to tell this apart from similar skin conditions including simple callus and dorsal cutaneous pads.


More About Knuckle Pads:

As mentioned earlier, there isn’t much known about knuckle pads or why they occur. Here is a little more information on the condition and its link to Dupuytren's disease:


  • Knuckle pads tend to precede Dupuytren's disease
  • Some individuals may end up with callused skin due to local irritation
  • The condition is known to resolve spontaneously
  • Some patients report symptoms including pain and redness
  • It is common for knuckle pads to recur after a while including after excision
  • Knuckle pads may be located centrally over the joint’s over the PIP head condylar prominences 
  • The same joint may have one or several knuckle pads 
  • The PIP joint is the most commonly affected joint but other joints including the DIP, IP, and MCP joints may also get affected
  • Can occur on fingers that are not affected by the palmar Dupuytren's disease

What Does Science Say?

We must mention that the condition (knuckle pads) is not exclusive to those suffering from Dupuytren's disease. You may develop the condition even if you do not have Dupuytren's contracture. However, those suffering from Dupuytren's contracture are said to be four times more likely to report the condition.

In addition to this, remember that the presence of knuckle pads doesn’t imply a more aggressive Dupuytren's disease.

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