Introduction
Dupuytren’s disease (also called Dupuytren’s contracture) is a progressive hand condition where thickened tissue under the skin of the palm forms knots and cords, eventually pulling one or more fingers into a permanently bent position. Primarily affecting the ring and little fingers, it can impair hand function. Though not life-threatening, it can significantly impact daily activities.
Causes and Risk Factors
The exact cause is unknown, but several factors increase risk:
- Genetics: Runs in families (common in Northern European descent).
- Age/Gender: More frequent in men over 50.
- Lifestyle: Associated with smoking, alcoholism, and diabetes.
- Medical Conditions: Linked to epilepsy, liver disease, and HIV.
Symptoms and Progression
- Early Stage:
- Small, painless lumps/nodules in the palm.
- Skin puckering or dimpling.
- Advanced Stage:
- Cords of tissue form, pulling fingers toward the palm (contracture).
- Difficulty straightening fingers, gripping objects, or placing hand flat.
Note: The condition is usually painless but can cause discomfort in later stages.
Diagnosis
A doctor (often a hand specialist) diagnoses Dupuytren’s through:
- Physical examination (checking for nodules/cords).
- Tabletop Test: Inability to flatten the hand on a surface.
- Imaging (rarely needed unless surgery is planned).
Treatment Options
1. Non-Surgical Treatments
- Needle Aponeurotomy (NA): A needle breaks cords to improve mobility.
- Collagenase Injections (Xiaflex): Enzyme injections dissolve cords.
- Radiation Therapy: Early-stage treatment to slow progression.
- Physical Therapy: Stretching exercises to maintain flexibility.
2. Surgical Options
- Fasciectomy: Removal of affected tissue (most common surgery).
- Dermofasciectomy: Removal of tissue + skin grafting (severe cases).
3. Alternative/Supportive Care
- Splinting: Post-treatment to maintain finger extension.
- Steroid Injections: For painful nodules (temporary relief).
Prevention and Management
While Dupuytren’s can’t be fully prevented, these steps may help:
- Avoid smoking and excessive alcohol.
- Manage diabetes and other linked conditions.
- Early intervention if nodules appear.
Prognosis
- Slow progression: May take years to worsen.
- Recurrence common: Even after treatment, cords may return.
- Functional outcomes: Most patients regain hand use with therapy.
Conclusion
Dupuytren’s disease is a manageable but incurable hand condition. Early diagnosis and tailored treatments (like Xiaflex or surgery) can restore function. If you notice palm nodules or finger bending, consult a hand specialist promptly.
FAQs
Q1: Is Dupuytren’s disease the same as “Viking disease”?
Yes! It’s nicknamed “Viking disease” due to its high prevalence in Scandinavian populations.
Q2: Can Dupuytren’s affect both hands?
Yes, about 50% of cases involve both hands (bilateral).
Q3: Is it related to arthritis?
No, it’s a connective tissue disorder, not joint-related.
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