A 75-year-old man with atrial fibrillation taking amiodarone and apixaban, heart failure with an ejection fraction of 20%, and long QT interval presented for evaluation of progressive swelling and erythema of the right fifth finger over 5 months. He had no known trauma to the hand or unusual exposures. He owned a cat and enjoyed the outdoors. On examination, he had a small nodular papule on the right fifth digit with surrounding fusiform swelling and erythema (Figure 1). The left hand was unaffected.