Dupuytren’S Disease

Dupuytren’s disease also known as Morbus Dupuytren, and palmar fibromatosis.

Dupuytren’s disease is a connective tissue disorder of the hand which involves the skin and bands of the fibrous tissue called fascia.

Fascia lies under the skin of the fingers and palms of the hand. Abnormal thickening of the fibrous tissue can lead to shortening and thickening of tendons that cause the flexion of the small or ring fingers towards the palm side and unable to extend them fully called Dupuytren’s disease.

It can affect both hands at the same time but is more commonly occurring in the right hand as compared to the left hand.

Causes of Dupuytren’s disease:

●  Genetic factor plays a very important role in this. History of Dupuytren’s disease in the family can increase the chances of getting affected by Dupuytren’s disease.

●  Abnormal proliferation of the fibroblasts can cause Dupuytren’s contracture. Myofibrils are the basic unit of muscles that allow the muscles to contract but the abnormal proliferation of the myofibroblasts can cause excessive contraction of fingers. Increased contracture can cause excessive secretion of type 3 collagen protein that results in an abnormality of the connective tissue.

● Smoking
● Extreme alcohol consumption

● Diabetes
● Hyperlipidemia ● Liver disease
● Thyroid disease.

Symptoms:

●  Dupuytren’s disease is a slowly progressive disease that started from the nodule in the palm of the skin. In the beginning, it can be painful but pain disappears after some time.

●  These nodules start growing and become thick hard cords that result in flexion of the fingers of the palm side with the inability to extend the fingers.

●  Dupuytren’s disease mainly occurs in the ring finger or small finger.

●  Difficulty in holding large things.

●  Dupuytren’s disease can occur in the feet and penis.

●  Presence of pit marks in the palm of hands.

Diagnose:

● Physical examination of the palm of the hands. Inspection: to see if there are pit marks or nodules on the

palm of hands and bent fingers.

● Table-top test: in this test a person has to put his/her hand on the surface of the table and ask him to flatten the palm of the hand. Unable to extend the fingers are a positive sign of Dupuytren’s disease.