Dupuytren's Disease

What is it?: Dupuytren’s disease often limits movement of the fingers by an abnormal thickening of the palm. More advanced cases are associated with loss of full extension of the involved finger because of a cord that stretches from the palm to the fingers (see diagram 1). Hands affected by Dupuytren’s disease are usually deformed but the disease does not cause pain. The cause is not yet known and no cure has been found.

Who gets it?: Most people with Dupuytren’s disease are white with ancestors from Northern Europe. Men are more often affected than women and the disease usually starts after age 40. Often the disease runs in families. Some individuals are prone to a more severe form of the disease. These may be persons who:

• develop the disease at an early age
• have the disease in other areas
• have liver disease from alcohol abuse
• take medications to control seizures

Hand injuries have not been found to cause the disease.

What are the symptoms?: The first sign of Dupuytren’s disease is usually a small lump or pit in the palm. The area most commonly affected is near the crease of the hand close to the base of the ring and small fingers (see diagram 2). As the disease progresses, the cord may develop between the palm and fingers. Most patients notice the problem when they cannot place the affected palm flat on an even surface. In more severe cases, the fingers will be drawn into the palm and will interfere with activities such as washing hands, putting on gloves, and placing the hand into a pocket.

Progression:

• the disease most often starts in the palm of the hand at the base of the ring or small fingers
• a lump or pit may show up months or years before a cord develops from the palm to the fingers
• the disease often affects both hands
• the fingers can be drawn into the hand at the joints at the base of the fingers or at the joints in the fingers
• the skin is often involved with the disease, but the tendons of the hand are not affected
  

Treatment: There is no known cure for Dupuytren’s disease. Surgery can relieve the pulling of the fingers into the palm, but the condition may in a some cases return with time. The goal of surgery is to restore normal motion to the fingers.