Careers  |  Sign In  |  Register  |   Twitter

10-Year-Old Boy with Multi-finger Asymptomatic Lesions

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

The mother of a 10-year-old boy brings him in for evaluation of his moles (which are all benign). During the visit, the mother asks about the lesions on the first 2 knuckles of his right hand; she initially noticed them several months earlier. The boy is otherwise healthy.

What is your clinical impression?

Choose one to reveal diagnosis and discussion

Warts
Psoriasis
Lichen planus
Dermatomyositis
Trauma

Answer: Trauma (knuckle biting)

See the full case at Consultant360

Further questioning revealed that the patient had a “nervous,” or compulsive, habit of chewing and biting on his knuckles, especially during stressful situations at school.

Warts would have a more verrucous appearance, and psoriasis would be more erythematous and scaly. Lichen planus is characterized by polygonal purplish papules, which are unlike the changes seen here. Dermatomyositis can produce erythematous papules overlying the joints of the hands; however, these lesions are associated with proximal muscle weakness, which was absent in this healthy 10-year-old boy.

More Cases
45-Year-Old Female with Asymptomatic Solitary Papule

Can you identify this skin ailment? Take this week's Derm Case Challenge to validate your diagnosis.

45-Year-Old Female with Asymptomatic Solitary Papule
38-Year-Old Male with Left Thumb Lesion

Derm Case Challenge

38-Year-Old Male with Left Thumb Lesion
75-Year-Old Female with Rash on Lower Extremities

Test your dermatology knowledge with this week's Derm Case Challenge.

75-Year-Old Female with Rash on Lower Extremities
40-Year-Old Male with Growing Lesion on Back

Can you identify this skin ailment? Take this week's Derm Case Challenge to validate your diagnosis.

40-Year-Old Male with Growing Lesion on Back
45-Year-Old Male with Photodistributed Rash

Derm Case Challenge

45-Year-Old Male with Photodistributed Rash
46-Year-Old Female with Knee and Lower Back Aches

Derm Case Challenge

46-Year-Old Female with Knee and Lower Back Aches
75-Year-Old Female with Rash on Lower Extremities

Test your dermatology knowledge with this week's Derm Case Challenge.

75-Year-Old Female with Rash on Lower Extremities
40-Year-Old Female with Inframammary Rash

Derm Case Challenge

40-Year-Old Female with Inframammary Rash
42-Year-Old Male with Abnormal-Looking Thumbnails

Test your dermatology knowledge with this week's Derm Case Challenge.

42-Year-Old Male with Abnormal-Looking Thumbnails
27-Year-Old Male with Bumps on Scalp and Neck

Derm Case Challenge

27-Year-Old Male with Bumps on Scalp and Neck