• Knuckle pads occur from benign thickening of the skin, principally the epidermis, and are occasionally seen in children. Despite the name, knuckle pads most commonly overlie the proximal interphalangeal joints. They must be differentiated from a variety of other cutaneous abnormalities. There is no consistently effective treatment, but knuckle pads have been reported to resolve spontaneously in children.
Paller AS, Hebert AA. Knuckle Pads in Children. Am J Dis Child. 1986;140(9):915–917. doi:10.1001/archpedi.1986.02140230085039