PMC5822890_01
Periarticular nodules involving mainly the PIP joints of the 2nd to 4th finger of both hands.
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fig1
On physical exam, a nodular swelling was noted adjacent to the PIP and to a lesser extent the metacarpophalangeal (MCP) joints of both hands (Figure 1).
Histological examination revealed coarse dermal collagen bundles with perieccrine collagen deposition, increased fibroblasts, reduction in elastic fibers, and scant perivascular lymphocytic inflammation (hematoxylin-eosin stain; original magnification x10).
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fig2
Histological examination revealed coarse dermal collagen bundles with perieccrine collagen deposition, increased fibroblasts, reduction in elastic fibers, and scant perivascular lymphocytic inflammation (Figure 2).
Alcian blue stain showing increased dermal mucin deposition (Alcian blue; original magnification x10).
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fig3
Furthermore, alcian blue and colloidal iron confirmed increased dermal mucin deposition (Figure 3).
PMC5822890_02
Periarticular nodules of the PIP and DIP joints.
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fig4
Physical exam revealed a nodular prominence, with mild tenderness, in the area of her PIP and DIP joints of the right hand (Figure 4).
Histology examination showed increased collagen bundles, increased fibroblasts, reduction in elastic fibers, and scant perivascular lymphocytic inflammation (hematoxylin-eosin stain; original magnification x4).
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fig5
Histology showed increased mucin deposition in the full thickness of the dermis, strongly positive for alcian blue and colloidal iron staining (Figures 5 and 6).
Alcian blue stain showed increased mucin deposition in the full thickness of the dermis (Alcian blue; original magnification x10).
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fig6
Histology showed increased mucin deposition in the full thickness of the dermis, strongly positive for alcian blue and colloidal iron staining (Figures 5 and 6).