What are knuckle pads?
Knuckle pads are smooth, round, skin-coloured nodules that develop on the back of hand. They are typically located over the proximal interphalangeal joint located at the middle joint of each finger. Sometimes they occur on the large knuckles as well.
Knuckle pads are also called Garrod's Pads -- named after the doctor who first documented these pads in medical literature.
Knuckle pads are round and vary in size. They can grow up to 15mm in diameter in a short period of time. They are different shades of skin-toned flesh with a smooth surface. Knuckle pads can be mistaken for warts or other callus formations.
Knuckle pads can be inherited, develop for no apparent reason, can appear after repetitive trauma or with other disease processes. They are often seen on the hands of people whose knuckles are exposed to repeated rubbing, such as boxers or production line workers. They can develop at any age, although more commonly after age 40. Children who suck their fingers can develop knuckle pads. They frequently accompany Dupytren's disease -- a condition that causes the fascia of the hand to progressively contract.
Typically knuckle pads by themselves do not affect function and medical intervention is not required. However, if knuckle pads are a result of repetitive trauma, steps can be taken to reduce this exposure. This includes wearing gloves or eliminating the activity causing the trauma. Medical intervention includes injecting steroids into the lesions, topical application of chemicals that break down and soften the tissue, psychological intervention to reduce behaviours that contribute to the problem and even radiation.
Surgical intervention is not typically recommended for knuckle pads. In children, this condition often resolves itself with time. Surgical intervention produces more scar tissue which can cause even larger lesions to develop in the area. Knuckle pads have a high recurrence rate in adults, making surgical intervention a temporary solution.
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