Teenage boy with thickened dorsal hands and feet

The boy with thick fingers

“…The underlying pathogenesis remains speculative though mechanical stimulation is implied in its causation. [12] It has also been associated with many psychiatric disorders including mental retardation and Asperger syndrome. It can present with joint pain in addition to cutaneous involvement, and hence can be confused with close differential diagnoses such as juvenile idiopathic arthritis, rheumatoid arthritis, pachydermoperiostosis, thyroid acropachy, acromegaly, and knuckle pads.…”