Dupuytrens contracture

Synonym(s)

Palmoplantar fibromatosis; Dupuytren's disease, palmar fasciitis; Viking disease

Definition

Disorder characterized by subcutaneous fascia thickening and shortening, causing the fingers to retract down towards the palm of the hand

Pathogenesis

Unclear; dominant genetic inheritance; often involves individuals of northern European descent; trauma sometimes initiates or accelerates the process; associated with alcoholism, diabetes mellitus, smoking, epilepsy, pulmonary disease

Clinical manifestation

Asymptomatic, palmar skin nodule, generally within the distal aspect of the palm, often with puckering of the skin above the nodularity; overlying skin sometimes adherent to the fascia, and fibrous cord sometimes extending into the finger; ring finger most commonly involved site, followed by the small finger

Differential diagnosis

Trigger finger

Dyshidrotic eczema 195

Therapy

Physical therapy in early stages*; intrale-sional triamcinolone 3-5 mg per ml; partial surgical fasciectomy for a patient with significant functional disability

References

Saar JD, Grothaus PC (2000) Dupuytren's disease: An overview. Plastic & Reconstructive Surgery 106(1):125-134

Dyshidrotic eczema. Multiple vesicles on the hands, with concentration along the sides of the digits

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