Hardened skin and blackening of the knuckles on the back of the hand may be related to sclerosing skin diseases or metabolic abnormalities.

This symptom may be caused by sclerosing skin diseases such as systemic sclerosis, or it may be related to conditions such as psoriasis and diabetes. These diseases can lead to changes in the structure of skin tissue, resulting in hardening and pigmentation. It is recommended to seek medical attention promptly to determine the specific cause and receive appropriate treatment.

Sclerosing skin diseases: Systemic sclerosis is an autoimmune disease that causes hardening and discoloration of the skin. Skin conditions such as psoriasis and vitiligo can also lead to skin hardening and pigmentation.
Metabolic abnormalities: Certain metabolic disorders, such as hypothyroidism or hyperadrenocorticism, can also affect skin health, manifesting as skin hardening and pigmentation.
Patients should avoid contact with irritants, keep their skin clean and dry, and wear loose, breathable clothing to reduce friction and pressure on their hands. At the same time, a balanced diet, with increased intake of vitamins C and E, will help improve skin condition.