An erythematous flag on the fingers

An unusual rash over a patient’s proximal interphalangeal joints raises suspicion
Kai Ting Chong
Figure 1. Erythematous scaly rash of the fourth and fifth proximal interphalangeal joint.

Viola is a 71-year-old Caucasian woman who presents to her GP for a routine iron infusion for recurrent iron deficiency.

At review prior to the procedure, Viola’s GP incidentally notices a rash on the proximal interphalangeal joints of the fourth and fifth digits of her right hand (see figure 1).