Knuckle pads are smooth, firm papules, nodules, or plaques that are wellcircumscribed. They are usually asymptomatic and overlie the dorsal hand joints; the thumbs and toes are less commonly affected. Most reported cases of knuckle pad lesions occur over the Proximal Interphalangeal (PIP) joints rather than the Metacarpophalangeal (MCP) joints. Ultrasonography and histopathology can diagnose knuckle pads and differentiate them from any swelling affecting the joints. Knuckle pads usually appear in the third decade of life. A case of knuckle pads will be described based on clinical, histopathological findings as well as the use of dermoscopy and ultrasonography in a 9 year old male child with no family history of the condition.
