What is Dupuytren’s disease and what causes it?
Dupuytren’s disease is a fairly rare condition that affects the palmar fascia, which is the layer of tissue found under the skin of the palm of the hand. If you look at your hand, it is easy to see that the palm is very different from the back of the hand, where the skin is much looser. The way the skin grips the hand and fingers on the palm side is due to that layer of fascia. It is what gives us our ability to grasp and hold objects with the level of dexterity that we possess.
The fibrous part of the fascia is held together by collagen. For those with Dupuytren’s disease, something has gone wrong and the normal process of old collagen being replaced with new does not happen the way it should. This results in a buildup of collagen under the skin in the palm. Lumps form that eventually turn into cordlike bands that affect the ability of the fingers to move and eventually pull them toward the palm. Once this happens, the condition is usually referred to as Dupuytren’s contracture.
Once the fingers have been affected to the point where they are pulled toward the palm, it is usually permanent, unless your doctor recommends one of the methods currently being used to soften or break apart the tissue. It is almost always the little finger and the ring finger that are affected; rarely does the condition move toward the thumb.
What Causes Dupuytren’s Disease?
Not a lot is known about the origins of Dupuytren’s disease. Some references refer to it in connection with the Vikings but no one knows who actually discovered it. The condition got its name from Baron Guillaume Dupuytren, the most prominent surgeon in France during the 19th century. Baron Dupuytren did not claim discovery. His only contribution seems to have been discussing it in a lecture.
Medical science may know more about Dupuytren’s disease than they did in Baron Dupuytren’s time, but they still do not know what causes it. It is currently believed that evidence suggests heredity may play a role, but researchers have not yet determined that to be conclusive. Nor is there any compelling evidence that the condition is brought on or aggravated either by trauma to the hand or overuse.
There is, however, reason to believe that certain factors increase the risk or likelihood of developing Dupuytren’s disease. The ones that researchers are most confident about include:
- As age increases so does the incidence of the disease
- Heredity is thought to be a factor, especially because it tends to appear in successive generations of those from European and Scandinavian countries
- Men are almost four times more likely to develop this disease than women
- Some medical conditions, diabetes and seizure disorders in particular, seem to be related to a higher rate of Dupuytren’s also
- Smoking and alcohol appear to increase risk
While there is no cure, treatment options for Dupuytren’s range from medication to surgery. Currently, most of these options are likely to only provide temporary relief.
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Posted in: Hand & Wrist