Dupuytren's contracture
Overview
Dupuytren's (du-pwe-TRANZ) contracture is a hand deformity that usually develops over years. The condition affects a layer of tissue that lies under the skin of your palm. Knots of tissue form under the skin — eventually creating a thick cord that can pull one or more fingers into a bent position.
The affected fingers can't be straightened completely, which can complicate everyday activities such as placing your hands in your pockets, putting on gloves or shaking hands.
Dupuytren's contracture mainly affects the two fingers farthest from the thumb, and occurs most often in older men of Northern European descent. A number of treatments are available to slow the progression of Dupuytren's contracture and relieve symptoms.
Symptoms
Dupuytren's contracture typically progresses slowly, over years. The condition usually begins as a thickening of the skin on the palm of your hand. As it progresses, the skin on your palm might appear puckered or dimpled. A firm lump of tissue can form on your palm. This lump might be sensitive to the touch but usually isn't painful.
In later stages of Dupuytren's contracture, cords of tissue form under the skin on your palm and can extend up to your fingers. As these cords tighten, your fingers might be pulled toward your palm, sometimes severely.
The two fingers farthest from the thumb are most commonly affected, though the middle finger also can be involved. Only rarely are the thumb and index finger affected. Dupuytren's contracture can occur in both hands, though one hand is usually affected more severely.
Causes
Doctors don't know what causes Dupuytren's contracture. There's no evidence that hand injuries or occupations that involve vibrations to the hands cause the condition.
Risk factors
A number of factors are believed to increase your risk of the disease, including:
- Age. Dupuytren's contracture occurs most commonly after the age of 50.
- Sex. Men are more likely to develop Dupuytren's and to have more severe contractures than are women.
- Ancestry. People of Northern European descent are at higher risk of the disease.
- Family history. Dupuytren's contracture often runs in families.
- Tobacco and alcohol use. Smoking is associated with an increased risk of Dupuytren's contracture, perhaps because of microscopic changes within blood vessels caused by smoking. Alcohol intake also is associated with Dupuytren's.
- Diabetes. People with diabetes are reported to have an increased risk of Dupuytren's contracture.
Complications
Dupuytren's contracture can make it difficult to perform certain functions using your hand. Since the thumb and index finger aren't usually affected, many people don't have much inconvenience or disability with fine motor activities such as writing. But as Dupuytren's contracture progresses, it can limit your ability to fully open your hand, grasp large objects or to get your hand into narrow places.