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Psychologically disturbed children who bite and suck their fingers cause thickenings that resemble knuckle pads to occur in the skin in the traumatized areas. Patients with bulimia who use their knuckles or fingers to induce emesis sometimes develop fibrotic papules resembling knuckle pads. [8] Some cases of knuckle pads are familial.
Circulatory Causes. Disorders that decrease circulation to the legs can cause aching and fatigue. An example of such a disorder is peripheral arterial disease, or PAD. PAD is caused by atherosclerotic plaques that block arteries in the extremities, similar to the plaques that block coronary arteries in coronary artery disease.