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By Stephen M. Schleicher, MD, and Yong J. Zhu, DPM
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CASE:
A 65-year-old man complains of a painful lesion on his finger that appeared approximately three weeks ago. He gives a history of arthritis. Examination of the affected digit reveals a 0.5-cm translucent, shiny nodule with a slightly erythematous border situated on the distal phalangeal joint. Light palpation elicits tenderness and expresses a viscous fluid.
WHAT IS YOUR DIAGNOSIS?
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A digital myxoid cyst is a flesh-colored-to-translucent papule or nodule located on either a finger or a toe and filled with hyaluronic acid, which has a jellylike consistency. Many cases arise secondary to friction or minor trauma and are associated with a history of osteoarthritis. Typical locations are the distal interphalangeal joint and the proximal nail fold. Asymptomatic cysts do not require therapy. Painful lesions may be drained, but they will frequently recur. |
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Dr. Zhu is a dermatology podiatry fellow at St. Luke’s Hospital in Allentown, Pennsylvania. Dr. Schleicher is director of DermDx Centers and a clinical instructor of dermatology at the Philadelphia College of Osteopathic Medicine, at Kings College in Wilkes-Barre, Pennsylvania, and at Arcadia University in Glenside, Pennsylvania. He is also a member of the emergency medicine editorial board.
Emerg Med 39(6):55-6, 2007
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