i've recently seen a healthy 8 year old girl with puffy swellings and some skin thickening over the surface of most of her IP joints, starting with the thumbs and spreading to other joints over a few weeks. The hand surfaces and other hand areas appear normal. The swellings seem to hold some fluid and the skin surfaces have taken on a chronic darker hue after a family MD treated the areas with an anti-fungal cream. The joints work fine, there's no systemic symptoms and no pain. No unusual activities or apparent contacts of note.
David F Smith, MD FRCP(C), a Vancouver pediatrician.