Dupuytrens disease

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Dupuytren’s disease affects the tissue under the skin of the palm. It causes nodules of tissue to develop, which may stiffen, pulling the fingers into a bent position.

The condition most commonly affects the ring and little finger but can occur anywhere in the palm of the hand . One or both fingers may become bent which can make certain everyday activities difficult and uncomfortable. Dupuytren’s disease most often occurs in older men and is most common in Northern Europe. It normally progresses slowly over several years though progress is unpredictable.

Causes of Dupuytrens disease

Dupuytren’s disease is primarily genetic in nature (80% of sufferers will have the disease in their family), however certain factors appear to increase your risk of developing the condition. These include:

  • Being over the age of 50.
  • Being a male of Northern European descent.
  • A family history of the condition.
  • Having diabetes.
  • Smoking and drinking alcohol.
  • Trauma

Symptoms of Dupuytrens disease

Dupuytren’s disease normally begins with the connective tissue under the skin on the palms becoming thicker and starting to pucker or dimple.

A lump may develop on the palm and as the condition progresses cords of tissue start to form under the skin. These contract, causing the fingers to be pulled towards your palm, resulting in deformity of the hand. It should be noted these tight cords are not the tendons.

Usually people will complain of

  • Not being able to get their hand flat
  • Not being able to put their hand in their pocket
  • Their finger going up their nose when washing their face
  • Not being able to put gloves on in cold weather

Diagnosis of Dupuytrens disease

The condition is normally diagnosed from examination. The doctor will check for thickening and dimpling of the skin on the palms. By pressing on the palms, it is normally possible to feel for toughened bands of tissue below the skin.

You may be asked to put your hand flat against a surface to see if you can fully straighten your fingers.

Treatment of Dupuytrens disease

Because the disease progresses slowly, it may not always require treatment. However, once it reaches the stage where it is impacting day-to-day activities you may be offered treatment to break up or remove the fibrous cords of tissue under your skin. Possible treatments include:

  • Needle Aponeurotomy / Fasciotomy – this uses a needle to break up the cords of tissue. It is normally an effective treatment although the problem can recur and not every area can be treated as there is a risk of nerve or tendon damage.
  • Surgery – may be used for people with advanced Dupuytren’s disease. It involves removing the tissue that is affected by the condition. In the most severe cases all of the tissue that is likely to be affected by the disease is removed. A skin graft is occasionally needed to close the wound and lengthy rehabilitation may be required to restore movement in the hand.

Consultants

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