Knuckle pads: Is there a topical treatment for these Garrods pads and my Dupuytren’s contracture?

I have DC and also knuckle pads or (Garrods pads) too…… Are there any topical treatments that can be useful in reducing the size of these knuckle pads?


Knuckle pads or Garrod’s pads  (or Garrod’s disease) are another of the excess fibrous tissue problems that affect people who have ancestry from northern Europe.  In the case of knuckle pads the problem appears as a clearly defined thickening and darkening of the tissue of the knuckles of one or both hands.  When a person develops this problem it usually affects the knuckles of all fingers, not just one or two.

They are located at the base of fingers or the first joint up from there at the  proximal interphalangeal or PIP joints of the hands.    They appear as a smooth, firm, slightly tender and slightly darker skin-colored elevation ranging anywhere from .25 to 1.5 inches in diameter. 

Knuckle pads or Garrod pads are commonly associated with Dupuytren contracture.  They are seen in about half of the cases of Dupuytren’s contracture; when they occur usually indicate a more severe form of Dupuytrens disease.

Over the years I have communicated with people who have noticed their knuckle pads reduce in size and tenderness after following a standard treatment protocol as outlined in the DCI website. The typical response when the knuckle pads begin to reduce their size, thickness and soreness is for this change to happen rather early, sometimes even before the Dupuytren cords or nodules begin to soften or reduce in size.

All DCI related treatment of Dupuytren’s contracture includes topical treatment consisting of Dusa-Sal DMSO, Super CP Serum and Unique-E vitamin E oil.  If you have some special concern about the appearance of your hands and wish to concentrate treatment to the knuckles, I cannot think of a reason that you could not apply additional DMSO, copper serum and vitamin E to these ares.

If you need further information about the Alternative Medicine treatment of Dupuytren’s contracture and knuckle pads, please let me know.  TRH 

Dupuytren Contracture and Knuckle Pads

Knuckle pads are a variable finding of many conditions

Knuckle pads or Garrod pads are commonly associated with Dupuytren contracture.  They are well-circumscribed, smooth, firm, and skin-colored slight elevations, papules, or nodules, approximately 0.5-3 cm in size.  They are most commonly found on the back side of the hand at the main knuckles joints (metacarpophalangeal or MCP) and the first joints after them (the proximal interphalangeal or PIP), with the PIP being the most common site.  They are not to be confused with a Dupuytren cord which is a structure associated with the lump on palm of the hand.

When associated with Dupuytren contracture, since they occur in 45-55% of cases, Garrod pads usually suggests a more aggressive representation of the disease (a Dupuytren diathesis).

When firm, the knuckle pads or nodules may be only tender to palpation, otherwise they do not cause pain or other symptoms.   These nodules are closely adherent to the skin in Dupuytren contracture while movement of the nodule during finger flexion/extension suggests an association with the tendon sheath.

A history of repetitive injury to this part of the hand from work or sports activity is often present, as well as occurring without any physical explanation.

Garrod first described knuckle pads in the medical literature in 1893, but knuckle pads have been observed since the Renaissance era; Michelangelo’s statue of David has knuckle pads (Florence, Italy) as well as his statue of Moses (Rome, Italy).

In the U.S and the rest of the world knuckle pads are thought to be a common occurrence.  The prevalence of knuckle pads is difficult to determine because this problem does not cause physical symptoms and so people do not often seek medical attention specifically for them. Knuckle pads can be present in any age group, with the most common in adults 40 years of age and older, especially males who engage in heavy manual labor.  The condition also is seen in young children who suck their fingers.

Some cases of knuckle pads are clearly familial, having no other possible causation.   Most often they are associated with other disease processes such as reported in Dupuytren disease, Peyronie disease, Ledderhose disease, pseudoxanthoma elasticum, esophageal cancer, hyperkeratosis, and oral leukoplakia.

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