Surfers' "Knots"

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Abstract
A few years ago, during the examination of a teenage boy for a completely unrelated skin complaint, firm, elevated lumps were noted just be low the knees. They were in a similar position to the lesions of housemaid's knee, but were hard plaques rather than cystic. On questioning the patient he explained that the lumps resulted from kneeling on a surfboard and demonstrated more lumps on the dorsum of both feet. He said that these were common among his surfer friends and was persuaded to return at a later date with several other young men, all of whom possessed like lesions. It was apparent that, despite the disfiguration and occasional discomfort produced by these swellings, they were definitely regarded as a status symbol, at least by this particular group of young men. Only a regular and enthusiastic surfer could acquire them! Surfers are rapidly increasing in number. While some of

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