What is the cause of Dupuytren disease?
It is usually familial disease with multifactorial causes. The tissue-level problem is a proliferative fibroplasias.
What are the diseases associated with Dupuytren disease?
1. Diabetes mellitus
2. Anti-convulsant therapy and epilepsy
3. Chronic alcoholism
4. HIV infection
5. Tobacco consumption
Is the disease related to work or trauma?
The disease has been noticed to increase in heavy manual workers or following injury to the hand.
Who gets this disease?
Typically Scandinavian or Northern European men (10:1 prevalence over women).
Where do they get it?
The most common fingers to get Dupuytren are the ring and small fingers.
What is Ledderhose disease?
Plantar fibromatosis.
What is Peyronie disease?
Penile fibromatosis.
Do these have anything to do with Dupuytren diathesis?
Yes. Dupuytren diathesis is the presence of a strong family history of Dupuytren disease associated with knuckle pads, Ledderhose or Peyronie disease. The patient often develops aggressive disease at a young age with a high likelihood of recurrence following surgery.
What are the risk factors in developing Dupuytren disease?
1. Family history
2. Other type of fibromatosis
3. Early and aggressive onset
4. Severe bilateral disease
What is Luck’s classification of the disease?
Three phases:
1. proliferative phase
2. involutional phase
3. residual phase
What is the difference between the collagen in normal fascia and that of the disease?
Normal fascia contains mostly type I collagen, whereas collagen in Dupuytren disease contains mostly type III collagen.
What cell type is implicated in Dupuytren disease?
The myofibroblast.
What other molecules may play a role in the development of Dupuytren disease?
Transforming growth factors (TGF-B), platelet-derived growth factor, fibroblast growth factor.
Cytokines, which are hormone-like peptides, may be responsible for which process in humans that can lead to Dupuytren disease?
Signaling the transformation of fibroblasts into myofibroblasts.
Name the normal fascia and their pathological forms in Dupuytren disease.
• Pretendinous band becomes pretendinous cord.
• Lateral digital sheet becomes lateral cord.
• Natatory ligament becomes natatory cord.
What other cords contribute to the disease?
Central and spiral cords.
What forms the spiral cord?
It is formed by the pretendinous band, spiral band, lateral digital sheet, and Grayson ligament.
What other ligaments in the hand are not affected by the disease?
• Superficial transverse ligament
• Deep transverse ligament
• Cleland ligament
• Landsmeer ligament
What causes metacarpophalangeal (MCP) joint flexion contracture in Dupuytren disease?
Pretendinous cord.
What causes proximal interphalangeal (PIP) joint flexion contracture in Dupuytren disease?
Spiral cord, lateral cord, and central cord.
What causes MCP adduction contracture in Dupuytren disease?
Natatory cords and the termination of the transverse fibers of the palmar aponeurosis.
Does the distal interphalangeal (DIP) get involved in Dupuytren disease? If so, how?
Yes, essentially by the retrovascular cord and to some extent by the lateral cord.
What is the key thing to remember about natatory cords?
They prevent abduction of the fingers at the MCP joints.
Related posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
