Lumps and Bumps on Hands: A Diagnostic Clue

In dermatology clinics we routinely come across cases of lesions on the hands. Patients may present with papules, vesicles, nodules on the hands. Such lumps and bumps on hands can be a manifestation of various diseases, ranging from benign lesions to systemic conditions. Routinely the rash on hands indicates primary skin disease. But lesions on hands can be seen in inflammatory conditions like psoriasis, eczema, rheumatoid arthritis, gout or infective diseases like bacterial (folliculitis, anthrax), viral (pox virus, herpetic whitlow, molluscum, wart), mycobacterial (tuberculosis verrucose cutis, lupus vulgaris), fungal infections (sporotrichosis). Few benign lesions like keratoacanthoma, ganglion or malignant conditions like SCC, Melanoma may present. A thorough examination and diagnosis of these lesions can provide valuable insights into underlying conditions. Here I am sharing interesting clinical cases highlighting the significance of hand lesions in diagnosing diseases like infective (secondary syphilis) and inflammatory conditions (gout, psoriatic arthritis) as well as clues to variety of systemic diseases (leprosy, tuberous xanthoma). Lumps and bumps on hands can serve as a valuable diagnostic clue to various diseases. The diagnosis of hand lesions is mostly clinical and depends on the clinical history and exploratory objective findings. A proper history taking, thorough clinical and systemic examination, combined with laboratory tests can aid in accurate diagnosis and timely management. Hand lesions may be a window of systemic disease.