Bluish, Tender Nodule on the Finger

M. Shane Chapman, MD


December 03, 2001

Clinical Presentation

52-year-old woman.

This woman complained of a nodule on her finger (Figure) that had been present for 5 weeks. She requested removal. After lidocaine anesthesia, the top of the papule was removed via shave technique, and the viscous material was forced out of the base of the nodule. The specimen was submitted to the pathology laboratory to confirm the diagnosis. No cautery, cryotherapy, or other destructive procedures were performed. The nodule returned at the same location 3 weeks later. The various treatment options were reviewed, and the patient opted for surgical excision.

Photo courtesy of Dr. Chapman.

Smooth, bluish, tender nodule over the distal metacarpophalangeal joint.

There was no deformity of the nail plate.

A cystic space separated from the epidermis by a mucinous stroma. There was a thickened epidermal collarette with thinning of the epidermis overlying the cyst. Collagen of the periphery was compressed. There was no epithelial lining.

What is your diagnosis?

  1. Orf

  2. Pyogenic granuloma

  3. Digital mucous cyst

  4. Milker's nodule

View the correct answer.