No racial predilection is associated with knuckle pads. Prevalence of knuckle pads is equal for men and women. Even in the presence of Dupuytren contracture, the prevalence of knuckle pads remains equal. They have been reported in young children who bite and suck their fingers. More commonly, knuckle pads are observed in adults older than 40 years.
Most patients are asymptomatic.
Firm skin-colored papules appear sequentially in multiple sites overlying the MCP and PIP joints of the hands. Individual lesions enlarge into well-defined plaques and nodules. Though complaints of pain or functional impairment of fine motor skills are rare, cosmetic concerns frequently are raised. A history of repetitive trauma often is elicited. If subjected to repetitive injury, knuckle pads may develop over virtually any bony prominence, but the PIP joint area is affected most commonly.