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February 10, 2010
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Dupuytren Contracture

Medical Author: William C. Shiel Jr., MD, FACP, FACR

What is a Dupuytren contracture?

Dupuytren contracture is a localized formation of scar tissue beneath the skin of the palm of the hand. The scarring accumulates in a tissue (fascia) that normally covers the tendons that pull the fingers to grip. As Dupuytren contracture progresses, more of the fascia becomes thickened and shortened. Dimpling and puckering of the skin over the area eventually occurs.

How fast does Dupuytren contracture develop?

Dupuytren contracture varies in its rate of progression from minor skin puckering for many years to rapid contracture (fixed flexed position) of fingers.

What are the causes of Dupuytren contracture?

The precise cause of Dupuytren contracture is not known. However, it is known that it occurs more frequently in patients with diabetes mellitus, seizure disorders (epilepsy), and alcoholism.

Dupuytren's contracture can be inherited. In medical terms, the inherited form of Dupuytren's contracture is transferred in the family as a so-called autosomal dominant trait with incomplete penetrance and partial sex-limitation. This means that the gene for Dupuytren contracture is not on an X or Y chromosome (sex chromosome) but on one of the other 44 chromosomes. Consequently, one version of the gene is enough to cause the disorder (it is dominant), but not everyone who has the gene has the disorder (the gene is not fully penetrant) and the disorder is most frequent in males (the gene expression is partially limited to males).

What are the symptoms of Dupuytren contracture?

Dupuytren contracture initially may cause only a minor painless lump in the palm of the hand near the base of the finger(s). Dupuytren contracture most commonly affects the ring (fourth) finger, but it can affect any and all fingers. Dupuytren contracture can also affect one or both hands.

As Dupuytren contracture progresses, it can lead to an inability to fully extend the affected finger from the flexed position. This can result in a loss of normal grasping.

Dupuytren contracture is seldom associated with much, if any, pain unless the affected fingers are inadvertently forcefully hyperextended.



Next: Is Dupuytren contracture limited to the hands? »

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Dupuytren Contracture

What is diabetes?

Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar (glucose) levels, that result from defects in insulin secretion, or action, or both. Diabetes mellitus, commonly referred to as diabetes (as it will be in this article) was first identified as a disease associated with "sweet urine," and excessive muscle loss in the ancient world. Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the urine, hence the term sweet urine.

Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level. In patients with diabetes, the absence or insufficient production of insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that alt...

Read the Diabetes article »




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