Dupuytren's Disease: Symptoms, Causes, and Treatment Options

Key Takeaways

This progressive fibrotic disorder primarily affects men of Northern European descent over age 40, with genetic factors accounting for up to 80% of cases.
The condition typically begins as small nodules in the palm that develop into thick cord-like bands over months to years, most commonly pulling the ring and pinkie fingers toward the palm.
Treatment becomes necessary when patients cannot lay their hand flat on a table (tabletop test) or when contracture reaches 20-30 degrees, indicating functional impairment.
Collagenase injections can dissolve the fibrous cords in 60-70% of patients within 24-72 hours, offering a less invasive alternative to surgical fasciectomy.
Recurrence rates vary significantly by treatment method—needle fasciotomy has 50-85% recurrence within 5 years, while surgical fasciectomy drops this to 10-20%.

Dupuytren's disease, also known as Dupuytren's contracture, is a condition that affects the tissue beneath the skin of the palm and fingers. If you or a loved one has been diagnosed with this condition, it's essential to understand the symptoms, causes, and available treatment options. This guide will provide you with a clear and concise overview of Dupuytren's disease.

What is Dupuytren's Disease?

Dupuytren's disease is characterized by the abnormal thickening and tightening of the fascia, the loose and flexible tissue beneath the skin of the palm and fingers. This condition most commonly affects the pinkie and ring fingers and usually involves both hands, although one hand may have worse symptoms than the other.

Dupuytren's Disease: Symptoms, Causes, and Treatment Options

Symptoms of Dupuytren's Disease

The signs of Dupuytren's disease appear in phases:

Nodules: Lumps under the skin in the palm of the hand are often the first symptoms. These lumps may feel tender and sore initially, but the discomfort eventually subsides.
Cords: The nodules cause tough bands of tissue to form under the skin in the palm, causing the fingers to bend or "curl" forward toward the wrist.
Contracture: As the curling worsens, it becomes difficult or impossible to straighten the fingers, leading to difficulty in performing everyday tasks such as picking up large objects or placing hands in pockets.

Causes and Risk Factors

The exact cause of Dupuytren's disease is unknown, but certain factors may increase the likelihood of developing the condition:

Excessive alcohol consumption
Diabetes
Seizures, such as those seen in people with epilepsy
Smoking
Having a relative with the condition
Being of Northern European or Scandinavian descent
Being a man over 40 years old

Diagnosing Dupuytren's Disease

To diagnose Dupuytren's disease, your healthcare provider will examine your hands, wrists, and fingers, feeling for nodules and assessing your ability to flatten your hands on a table. Additional tests may be performed to evaluate your hand function and range of motion.

Treatment Options for Dupuytren's Disease

While there is no cure for Dupuytren's disease, various treatment options are available to manage symptoms and improve hand function:

Non-Surgical Treatments

Steroid injection: Corticosteroid injections can help reduce pain and inflammation in tender nodules and may prevent finger contractures from worsening.
Enzyme injection: Collagenase (Xiaflex) injections can help dissolve the thick and tight tissue, allowing the doctor to stretch the affected area.

Surgical Treatments

Fasciotomy: This procedure involves dividing the thick cord of ligament tissue to allow the affected finger to move more freely.
Subtotal palmar fasciectomy: In this procedure, the doctor removes as much of the cord and tissue as possible to straighten the finger. Recovery can take several months and may require physical therapy and a skin graft.

Your doctor will help you determine the best treatment option based on the severity of your condition and your individual needs.

When to See a Doctor

If you experience any symptoms of Dupuytren's disease, such as lumps in your palm, difficulty straightening your fingers, or trouble grasping objects, it's essential to consult your doctor. Early intervention can help prevent the condition from worsening and improve your overall hand function.

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The Bottom Line

Early intervention when fingers begin curling prevents permanent joint damage and maintains hand function for daily activities. The tabletop test serves as a practical home assessment tool to determine when medical evaluation becomes necessary. If you're noticing palm thickening or finger contractures, Doctronic can help connect you with appropriate treatment options.