Dupuytren's disease is a collagen disorder that afflicts between 4–6 percent of people of Northern European descent. It occurs when the underlying layer of skin on the palm of the hand becomes abnormally thick and nodular. This thickening spreads into the fingers and causes the finger joints (primarily in the ring and little fingers) to contract and not extend easily or completely even with effort. Males are affected more often than females by a 3:1 ratio.
- Firm lumps or nodules in the palm of the hand (first stage)
- Involuntary contracting of the fingers, primarily the ring and little finger (later stage)
- Unilateral or bilateral
- Reduces flexibility and hand use, but not typically painful
In Dupuytren's disease, the body mistakenly begins to produce thick type III collagen in place of the thinner, more pliant type I collagen of the normal palm. The reason this mistake occurs is not clear, but heredity, a variety of behaviors such as smoking and excessive alcohol intake, and diseases like diabetes are correlated with higher risk. The thickened fascia in afflicted men has a high count of androgen receptors, which correlates with the higher proportion of men who develop Dupuytren's disease and their more severe symptoms.
Because it creates a non-reversible change in the nature of new tissue production in the hand, Dupuytren's disease cannot be cured. However, a hand surgeon can often provide effective relief of symptoms through treatment to make the hand more pliable. These treatment options include the following:
Collagenase: an injectable medication used to dissolve the nodule and some of the thickened tissues.
Needle Aponevrotomy: a minimally invasive procedure in which a small needle, inserted into the palm, is used to release the thickened cords and restore finger movement.