Abstract
Videogame controller–induced knuckle pads may present in a strikingly unique distribution. Successful paring without recurrence can be achieved when combined with removal of the original insult.
Keywords: knuckle pads, occupational dermatology, shave removal
Videogame controller–induced knuckle pads may present in a strikingly unique distribution. Successful paring without recurrence can be achieved when combined with removal of the original insult.
1. CLINICAL IMAGE
Knuckle pads are a benign and typically treatment‐resistant entity found on extensor surfaces of the fingers. We present a case of videogame controller–induced knuckle pads on the ulnar and radial surfaces of the digits. Successful treatment without recurrence was achieved when paring was combined with removal of the original insult.
A healthy 19‐year‐old male was referred to our clinic with concern for keratoderma given clinical diagnosis of knuckle pads. He presented with firm, nontender, hyperkeratotic papules on the ulnar surface of the proximal interphalangeal joints of the first digits and the radial surface of the second‐fourth digits bilaterally (Figure 1). These lesions had developed over three years and persisted despite cryosurgery. No family history of similar findings was noted. The patient and his mother believed them to be idiopathic. Upon examining the distribution, the patient was asked if he plays videogames. He played many hours per night, and the way he held the controller explained the striking distribution of the knuckle pads.
FIGURE 1.
Videogame controller–induced knuckle pads on the ulnar surface of the proximal interphalangeal joint of the first digits and the radial surface the second digits bilaterally
Knuckle pads are benign, hyperkeratotic papules, nodules, or plaques typically found on the extensor surfaces of the metacarpophalangeal or interphalangeal joints. 1 They may be idiopathic, disease‐associated, or related to repetitive trauma. 1 Frequent videogame use can result in trauma‐induced knuckle pads. 2 Topical therapy and local destruction typically result in high recurrence rates. 1
#15 blade paring of the lesions combined with physician‐directed behavioral modifications—limiting videogame controller use and taking frequent breaks—led to successful treatment (Figure 2). For trauma‐induced knuckle pads, we recommend paring and removing traumatic insults.
FIGURE 2.
Videogame controller–induced knuckle pads, post paring with a #15 blade
CONFLICT OF INTEREST
None declared.
AUTHOR CONTRIBUTIONS
All authors: made substantial contributions to the preparation of this manuscript and approved the final version for submission.
KF: performed literature search, drafted initial version of manuscript, and revised manuscript. SK: contributed significant revisions to the manuscript and acquired images. KP: contributed significant revisions to the manuscript.
ETHICS
Patient consent for publication available upon request.
ACKNOWLEDGMENTS
Published with written consent of the patient.
Flanigan K, Kent S, Anne Potter K. Shave removal for videogame controller–induced knuckle pads. Clin Case Rep. 2021;9:1812–1813. 10.1002/ccr3.3850
DATA AVAILABILITY STATEMENT
Data sharing is not applicable to this paper as no datasets were generated or analyzed.
REFERENCES
- 1. Hyman CH, Cohen P. Report of a family with idiopathic knuckle pads and review of idiopathic and disease‐associated knuckle pads. Dermatol Online J. 2013;19(5):18177. [PubMed] [Google Scholar]
- 2. Rushing ME, Sheehan DJ, Davis L. Video game induced knuckle pad. Pediatr Dermatol. 2006;23(5):455‐457. [DOI] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
Data sharing is not applicable to this paper as no datasets were generated or analyzed.