Knuckle pads as a psychocutaneous manifestation in a stressed-out child

Abstract

Knuckle pads (KP) are benign, firm papules, nodules, or plaques on the dorsal joints of the hands or toes. It's mostly idiopathic, also, children who bite and suck their fingers may have KP. An 11-year-old child was brought to our polyclinic with the complaint of thickness on his hand joints. The child was healthy otherwise, he didn't have joint pain and family history. He was questioned in terms of being under any kind of stress. He said that his schoolmates were always making fun of him. When he was asked if he was using his hands in those moments to relax, he said “yes” and showed the movement. His father confirmed that the kid was experiencing an adaptation problem in the school, then, he is referred to the department of child psychiatry. KP is associated with lots of factors but especially in children, it may be a psychocutaneous manifestation. Also, it may cause a social embarrassment triggering the vicious cycle of stress-related pathogenesis.