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What is Dupuytren's disease?

Treatment Fields > Radiology

What is Dupuytren’s disease?

Dupuytren’s disease involves the layer of fibrous tissue, called fascia that lies just below the skin of the palm. The palmar fascia reaches the upper area of the palm, where it separates into bands that extend into the fingers. These are called pretendinous bands. In Morbus Dupuytren, the fascia begins to thicken and produce visual changes in the palm. Many of these changes are caused by excess Collagen A protein that is normally part of many tissues in the body, like skin and fascia, build up in the fascia. An early sign of Dupuytren’s disease is the appearance of a lump, called a nodule, at the base of the finger , over the pretendinous band. As the disease progresses, fascia that extend into the fingers becomes involved, forming a rope-like cord that eventually pulls the finger downward resulting in a function deficit. This is called a finger contracture. Progression of Morbus Dupuytren is explained in more detail by your physician.

Dupuytren’s disease can affect one hand or both. It most commonly affects the 4th or ring finger and the little finger (5th). Contracture of the middle finger may also occur, but is less common. Index finger and thumb are rarely involved.

Who gets Dupuytren’s disease?
Dupuytren’s disease occurs predominantly in men. Although symptoms can appear between the age of 20 to 30, they typically do not appear until later. It usually affects men over the age of 50 and women over the age of 60. Dupuytren’s disease is more prevalent among individuals in Northern Europe but is also known in many other racial groups.

Causes of Dupuytren’s Disease:
The cause of Dupuytren’s disease is unknown. Genetic factors (family history) predispose some individuals to the disease. The influence of family history does not appear to be due to factors such as shared types of work. Individuals with strong family history of Dupuytren tend to develop signs of the disease at younger ages than those with no family history. Those with strong family history also tend to have more severe disease involving multiple fingers and both hands. Although genetics may be an important determinant for some individuals who develop Dupuytren’s disease, inheritable factors do not account for all cases. There are other factors that may increase the risk of Dupuytren’s disease, but a causal relationship has not been established.
These other factors include:

  • Diabetes , alcohol consumption, smoking, manual work and exposure to manual vibrations (e.g., from a jackhammer), Injury to the hand, epilepsy etc.

Diseases Associated with Dupuytren’s

In Dupuytren’s disease, abnormalities can occur in fibrous tissues in areas other than the palm of the hand. This is known as ectopic
disease. Individuals with more severe, rapidly progressing Dupuytren’s disease are more likely to develop these conditions.
Other areas affected include:

  • Fingers (Knuckles Pads ( = Garrod’s pads)

-enlargement of the knuckles can develop before other signs

  • Feet ( Plantar Nodules ( = Ledderhose disease)

- changes inthe fascia
underlying the skin on the underside of the feet cause nodules
- and can lead to contracture of the toes

  • Penis ( Nodules, Angulation = Peyronie’s disease)

-curvature of the penis

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