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September 1966


Arch Dermatol. 1966;94(3):379. doi:10.1001/archderm.1966.01600270129030

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Knuckle Pads. Presented by Lyon Rowe, MD, and A. J. Keiper, MD.  The patient was a 14-year-old female Guamanian. She has had the gradual development over the past few years of thickening of the skin over all the knuckles.

Discussion  Lyon Rowe, MD: The corium is essentially normal but there are changes in the epidermis. The epidermis is hypertrophic and there is hyperkeratosis with very little parakeratosis. There are also a few scattered clusters of vacuolated cells in the stratum granulosum.Apparently there are two types of knuckle pads histologically. In one, the essential change is fibromalike and located in the dermis. In the other type, to which our case belongs, the epidermis only is altered, and is hypertrophic and hyperkeratotic.Samuel Ayres, Jr., MD: A comprehensive review of knuckle pads by J. R. Allison, Jr., and J. R. Allison, Sr., was published in the Archives of

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