Unique digital skin lesions associated with systemic sclerosis

A 40-year-old woman with systemic sclerosis presented with multiple, large soft skin lesions with a cystic appearance over the interphalangeal joints of both hands. Aspiration of one of these lesions revealed the presence of a yellowish mucoid material which rapidly reappeared. Surgical dissection and excision of the masses was followed by recurrence a few months later. Pre-operative diagnosis was that of myxoid cysts, but the histological picture was reminiscent of cutaneous focal mucinosis, another form of primary mucinosis. The origin of these unique skin lesions is unclear, but speculation on a possible aetiological relationship between them and systemic sclerosis is presented.