What is Dupuytren's disease?

Dupuytren's disease is an abnormal thickening of tissue beneath the skin in the palm of the hand. The disease often develops in both hands, and it occasionally occurs in the soles of the feet. Dupuytren's (say "doo-pwee-TRAHZ") disease, which is also called Viking's disease, usually progresses very slowly and may never require treatment. In many cases the disease does not extend to the fingers but remains confined to the palm area. When the tissue between the skin and tendons (palmar fascia) thickens, it may eventually limit movement or cause the fingers to bend or flex so that they cannot be straightened (contracture). See an illustration of Dupuytren's contracture.

Dupuytren's disease occurs most often in people age 50 and older. While treatments are available, there is no permanent cure for Dupuytren's disease.

What causes Dupuytren's disease?

The cause of Dupuytren's disease is unknown. Heredity is thought to be a factor, since Dupuytren's disease tends to occur most often in people of northern European descent and among close family members. The thickening of the fascia may be related to alcoholism, smoking, or diabetes.

What are the symptoms?

Dupuytren's disease usually does not cause pain. When pain does occur, it often is early in the disease. This disease develops slowly: the first noticeable sign is often a small lump felt in the top of the palm usually where your ring and small fingers meet. As the disease progresses, a fibrous, ropelike cord may gradually develop in the palmar fascia and connect your palm to one or more fingers, usually the ring or small finger. The cord pulls your finger toward the palm, which is called Dupuytren's contracture. Eventually you may not be able to flatten your palm on an even surface, such as a table. When severe, Dupuytren's contracture can make certain everyday activities-such as picking up items, putting on gloves, or washing your hands-difficult or impossible.

How is Dupuytren's disease diagnosed?

Dupuytren's disease is usually diagnosed through a physical examination and medical history.

How is it treated?

The goal of treatment for Dupuytren's disease is to maintain or restore hand function. In mild cases, regular stretching of the involved fingers may be enough to maintain mobility. In severe cases, surgery is the main treatment and usually improves function. However, recurrence of Dupuytren's disease is common.

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