What is it
Dupuytren’s disease owes its name to the surgeon French Guillaume Dupuytren who first identified and described it.
It consists of a thickening and subsequent retraction of the palmar aponeurosis, the thin fibrous fascia that covers and wraps the muscles of the palm of the hand.
Following this thickening, due to the deposit of collagen fibers, there is a permanent flexion of one or more fingers of the hand.
How widespread is it
There are no precise estimates of the spread of Dupuytren’s disease. According to some studies, it seems that in Europe it affects about 13% of the population, with a greater frequency in the Nordic countries.
The disease mainly affects men and the elderly: in Italy the estimated prevalence is 25 percent among men over 50, while in the rest of the population it seems to be around 4 percent.
In any case, according to experts, these estimates are much lower than the real situation.
In 25% of cases, the disease evolves towards severe forms that compromise the normal performance of daily activities and work.
Symptoms
Dupuytren’s disease manifests itself at the beginning with the appearance of nodules in the palm of the hand that are often mistaken for calluses.
Gradually, since the aponeurosis affects the entire palm and then continues along the fingers, the finger bends, first at the level of the metacarpophalangeal joint, that is, the base of the finger.
Subsequently, and progressively, the joints that are in the middle of the finger.
Causes
The exact causes of Dupuytren’s disease are not known. There are hypotheses that have yet to be confirmed.
The following risk factors are known:
- familiarity
- insulin-dependent diabetes
- epilepsy
- smoke
- alcohol
Therapies
“Open-label” surgical treatment is currently the most common for the treatment of Dupuytren’s disease.
It consists in the complete removal of the palmar and/or digital aponeurosis portion affected by the disease (cord).
An alternative currently used is cordotomy or subcutaneous fasciotomy, i.e. the introduction of a needle through the skin to “break up” the cord, rather than removing it entirely.
Recently, a pharmacological therapy based on collagenase, enzymes able to “dissolve” collagen, has been put on the market in the USA (in Italy it is awaiting registration), which involves the injection of the active ingredient directly into the cord.
An operation, the latter, simpler than the previous ones, but which must in any case be performed by a hand surgeon.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.