Knuckle pads: Does knuckle cracking play an etiologic role?

Very little has been published on knuckle pads and the cosmetic and psychol ogical effects they can have. In children, most knuckle pads are considered to be idiopathic; however, familiar cases as well as those caused by traum a have been described, We report a 14-year-old African American girl with a 3-year history of slowly enlarging hyperkeratotic nodules over multiple fi nger joints and on the lateral aspects of several fingers, These lesions we re initially confined to the patient's left hand but subsequently involved the right hand. The patient and her mother denied any unusual hobbies or sp orts in which the patient's fingers might be traumatized. The patient, howe ver, was noted to crack her knuckles during her clinic visit, To the mother 's surprise, the patient admitted to doing this quite frequently on a daily basis. A diagnosis of knuckle pads was made and confirmed histologically. To our knowledge, this is the first reported case of knuckle pads with crac king of the knuckles as the possible etiology.