65-Year-Old With Finger Growth

A 65-year-old woman presents to urgent care complaining of a growth that developed on her finger 2 months prior. She says it’s not painful or itchy and has not grown since she first noticed it. On examination, a solitary, smooth, pinkish papule with a tiny central crust is seen on her distal interphalangeal joint on her left index finger. The patient has a history of osteoarthritis.

View the image below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.