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A 58-year-old gardener presents in the surgery with a respiratory infection.
While he is consulting, he mentions that he has noticed a hard lump on the palm of his right hand that has been present for several months. It is painless and is not affecting the function of his hand but he is interested to know the diagnosis.
He is hypertensive, his BP being well controlled on an ACE inhibitor and a diuretic, but is otherwise normally well.
On examination, there is a hard fibrous nodular band at the base of his ring finger. He has full movement of his fingers.
What is the diagnosis, differential diagnosis and management? …