PMC7074991_01
Clinical images of the patient (a) Reddish-purplish discoloration on the back of the distal and intermediate phalanges of the third and fourth finger as well as the third and fourth metacarpophalangeal joint. On the base of the erythema, there are several formed papules and nodules with a central golden scab. b Reddish-purplish nodule on the proximal forearm
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Fig1
Another 2 weeks later, she returned for a follow-up visit with new cutaneous findings: Clinical examination at that time revealed a visible and palpable swelling of the back of the right hand and third MCP joint (Fig. 1a). In addition to the findings on the right hand, a complete examination of the skin revealed a single reddish-purplish erythematous nodule in a linear "sporotrichoid" form on the right proximal forearm (Fig. 1b).
Ultrasound images of the third metacarpophalangeal joint. a Longitudinal view of the third metacarpophalangeal joint showing intense power doppler signaling III . b Longitudinal view of the carpal bones demonstrating tenosynovitis of the fourth extensor tendon sheath with power doppler signaling III
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Fig2
A musculoskeletal ultrasound was performed and showed tenosynovitis of the third extensor tendon with increased power doppler signal (Fig. 2a and b).