This 22 year old man presents with bumps on the back of his hands that have developed over 5 years. He does not do any work with his hands and reports that his hands are not involved with any repetitive motions or contacts. His mother has similar lesions and also a condition called Dupuytren’s contractures.

What is your diagnosis?

Diagnosis: Garrod’s knuckle pads: (Dupuytren’s nodular sub-type).

He has an inherited fibrosing disorder; most likely early Dupuytren’s disease. On examination he had no palmar contractures, nor any other bodily fibrosing involvement. He will now be followed by a hand specialist for both reactive and symptomatic care. Additionally he will be followed by his internist and a urologist for future progression and treatment.

Articles/links For additional information please see:
		MNEJ
		Dermnetnz.org
		emedicine
		http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1963648/
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