What Is the Growth on This Man’s Finger?

Authors:
Kenneth Benson, MD; Michael Crandall, MD; and Erin Storie, DO
United States Navy

Citation:
Benson K, Crandall M, Storie E. What is the growth on this man’s finger? [published online October 18, 2018]. Consultant360.

A 43-year-old white man presented to the dermatology clinic with a small growth on his left index finger that had been present and growing for the past 11 months. When questioned about the onset of the growth, he reported associated mild trauma to the finger approximately 12 months ago when he had burned it with a cigarette. He denied any discharge or pain. He also denied a reduction in the range of motion of the finger.

The patient did not have a history of skin cancer or tuberous sclerosis, he did not regularly use sunscreen, and he denied having any other suspicious lesions on his body. A 10-system review was unrevealing.

Physical examination. On examination of this Fitzpatrick skin type 3 patient, a dome-shaped, 7-mm diameter, smooth, firm, flesh-colored papule was present at the lateral aspect of the proximal interphalangeal joint of the index finger of the left hand (Figure). A thin, mildly scaly hyperkeratotic collarette was visible around the lesion. There was no appreciable erythema or hypervascularity, nor were any thrombosed capillaries present.

Figure. A dome-shaped papule at the proximal interphalangeal point of the first digit, with blue skin marker designating the site to be biopsied.

The patient was afebrile, with vital signs within normal limits. He was alert and oriented, well-developed, and in no distress. He was normocephalic, with no scleral icterus, and no cervical lymphadenopathy. He had nonlabored breathing and regular heart rate and rhythm.