case_images: PMC5822890_01
case_images: Periarticular nodules involving mainly the PIP joints of the 2nd to 4th finger of both hands.
case_images: CRIDM2018-9835279.001.jpg
case_images: PMC5822890_01_CRIDM2018-9835279.001.jpg
case_images: fig1
case_images: 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).
case_images: 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).
case_images: CRIDM2018-9835279.002.jpg
case_images: PMC5822890_01_CRIDM2018-9835279.002.jpg
case_images: fig2
case_images: Histological examination revealed coarse dermal collagen bundles with perieccrine collagen deposition, increased fibroblasts, reduction in elastic fibers, and scant perivascular lymphocytic inflammation (Figure 2).
case_images: Alcian blue stain showing increased dermal mucin deposition (Alcian blue; original magnification x10).
case_images: CRIDM2018-9835279.003.jpg
case_images: PMC5822890_01_CRIDM2018-9835279.003.jpg
case_images: fig3
case_images: Furthermore, alcian blue and colloidal iron confirmed increased dermal mucin deposition (Figure 3).
case_images: PMC5822890_02
case_images: Periarticular nodules of the PIP and DIP joints.
case_images: CRIDM2018-9835279.004.jpg
case_images: PMC5822890_02_CRIDM2018-9835279.004.jpg
case_images: fig4
case_images: Physical exam revealed a nodular prominence, with mild tenderness, in the area of her PIP and DIP joints of the right hand (Figure 4).
case_images: Histology examination showed increased collagen bundles, increased fibroblasts, reduction in elastic fibers, and scant perivascular lymphocytic inflammation (hematoxylin-eosin stain; original magnification x4).
case_images: CRIDM2018-9835279.005.jpg
case_images: PMC5822890_02_CRIDM2018-9835279.005.jpg
case_images: fig5
case_images: 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).
case_images: Alcian blue stain showed increased mucin deposition in the full thickness of the dermis (Alcian blue; original magnification x10).
case_images: CRIDM2018-9835279.006.jpg
case_images: PMC5822890_02_CRIDM2018-9835279.006.jpg
case_images: fig6
case_images: 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).