Dupuytren’s Disease

• is a progressive condition that causes the fibrous tissue of the palmar fascia to shorten and thicken. 
• common in men older than 40 years

• Risk Factors
  • Diabetes Mellitus (comorbid in 3-33% of diabetes)
  • Increased weekly Alcohol intake- Dupuytren’s does not suggest Alcoholism
  • Tobacco use
  • Trauma (inconsistent association from studies)
  • Anticonvulsants (inconsistent association from studies)

• Associated with
  • Plantar Fibromatosis
  • Peyronie’s Disease

• Symptoms
  • present with a small, pitted nodule (or multiple nodules) on the palm, which slowly progresses to contracture of the fingers. 

• Management
  • can be managed with observation and non-surgical therapy. 
  • It will regress without treatment in approximately 10 percent of patients. 
  • Steroid injection into the nodule has been shown to reduce the need for surgery. 
  • Surgical referral should be made when metacarpophalangeal joint contracture reaches 30 degrees or when proximal interphalangeal joint contracture occurs at any degree.

possible causes:

1. T-Cell-Mediated Autoimmune Disorder: Presence of CD3-positive lymphocytes suggests an autoimmune origin (Baird et al., 1993).
2. Stem Cells Origin: Abnormal cells might originate from fascia, palmar skin, and fat-derived cells (Hindocha et al., 2011).
3. Genetic and Environmental Factors: Genetics, smoking, alcohol intake, and diabetes are potential factors (Grazina et al., 2019).
4. Unknown Exact Etiopathology: Despite known factors, the exact cause remains unclear (Childs, 2005).
5. Hormonal Influence: Role of androgens and possibly protective estrogenic hormones is under investigation (Stahl & Calif, 2008).
6. Occupational Factors: Physical force and vibrations to the upper limbs might contribute or aggravate the disease (Descatha, 2012).