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Images in Dermatology
October 23, 2019

Milker’s Nodule

Author Affiliations
  • 1Department of Dermatology, Medical Trust Hospital, Cochin, Kerala, India
  • 2Faculty of Dermatology, College of Medicine, King Faisal University, Al Ahsa, Saudi
  • 3Department of Pathology, Medical Trust Hospital, Cochin, Kerala, India
JAMA Dermatol. 2020;156(1):93. doi:10.1001/jamadermatol.2019.3248

A man in his 20s presented with painful, red, raised lesions on the right and left hands that first appeared 20 and 10 days prior to examination, respectively. Detailed medical history revealed that he had been working part-time at a cattle farm milking cows over the previous 2 months. He had no significant medical history or any recent drug intake.

On examination, there was a targetoid, yellow nodule with a peripheral rim of erythema overlying the dorsal aspect of first metacarpophalangeal joint of the left hand. The dorsum of the right hand over the first web space showed an irregular yellowish plaque with central erosion and crusting (Figure). There was no local lymphadenopathy, and systemic examination was unremarkable.

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