What is Dupuytrens Contracture and can anything be done about it?
This is a genetically predisposed disease of unknown etiology, but is common in those countries that received the "Viking diaspora": ie Scandinavia, Britain, and then the British colonies. It is almost unheard of in native africans for instance.
The condition is simply a fibrous scar like affliction of the fascial layer of the palm. which is the layer that binds the skin of the palm or sole to the underlying skeleton. Without this layer the skin would skid about as it does on the back of the hand, preventing firm grasping. The first sign of the affliction is a nodule, usually in the palm in line with the ring or little finger. This may persist for mnay years without progressing. Conversely it may develop bands running from the lump to the finger and palpable beneath or even within the skin. These bands then contract slowly and draw the finger inexorably toward the palm. they may proliferate into other adjacent digits, or appear in the opposite hand, or foot. Very occasionaly they can afflict the penis.
There is no medical treatment, despite press hype to the contrary. Surgery is reserved for treatment of contractures and is NOT generally advisable for the isolated nodule, since the paradox of surgery is that it may hasten the development of the disease. Simple surgery is often effective, and further surgery may be necessary after some years if the disease progresses or appears elswhere. In sveere cases recurrence can be delayed or contained by careful use of skin grafts to eliminate involved skin areas in discrete zones of the hand.
There are associations with the disease, but no serious systemic manifestations, and there is no predisposition ot malignancy of any sort.