What is dupuytren's disease?

In Dupuytren's disease, the fingers become stiff and curl toward the palm. It is caused by thick tissue that grows under the skin in the palm of the hand. Sometimes the condition affects the palm but not the fingers. If the tissue gets thicker and affects one or more fingers, it may limit movement of your fingers and hand. The disease can cause your fingers to bend so you can't straighten them. This is called a contracture. Sometimes the condition can occur in the soles of the feet.

The cause of Dupuytren's disease is not known. It may get worse slowly. If you have a mild case, you may be able to keep your fingers moving with regular stretching. Surgery usually helps in severe cases. However, Dupuytren's disease can come back.

Dupuytren's disease has three general phases:

• In the early phase, you may see or feel a small lump in the palm of your hand, usually near where your ring finger and small finger meet.
• In the active phase, you may have dimpling on the skin of your palm. Long, ropey cords or bands form in the fascia. You may be able to see or feel them.
• In the advanced phase, a fibrous cord may form in the fascia that pulls your fingers toward your palm. This is called Dupuytren's contracture. Over time, you won't be able to straighten your fingers or flatten your hand on a table. It may be hard or impossible to do things like put on gloves, wash your hands, or pick up things.

In most cases, Dupuytren's doesn't cause pain. You may not even notice it until you develop a contracture.

The disease usually gets worse slowly. In many people, it never causes major problems.

The goal of treatment for Dupuytren's is to keep your hand working as well as it can. You may not need treatment unless you have a contracture. Treatment options include:

• Collagenase injection. A medicine called collagenase (such as Xiaflex) may be injected into the tight cord to try to dissolve some of the tissue. This may help reduce the contracture and improve your range of motion.
• Needle aponeurotomy (say "ap-uh-noo-RAH-tuh-mee"). A needle is used to make small holes in the tight cords in the palm. Then the fingers are extended to separate the cords.
• Surgery to remove or separate the affected tissue in the palm. A skin graft may be done to cover open areas in the palm.

A physical exam and medical history will usually give enough information for a doctor to decide if you have Dupuytren's disease. Your doctor will look for skin changes on your palm and feel for any knots or a cord. They may also watch you move your hand, wrist, and fingers.

• Follow your doctor's advice for physical or occupational therapy and exercises to put your fingers and hand through a range of motion.
• Two times a day, massage your hand and gently stretch the fingers back. This can get rid of tightness and help keep your fingers flexible.
• Try to avoid curling your hand tightly. For example, use utensils and tools that have larger hand grips.

In Dupuytren's (say "duh-pwee-TRAHNZ") disease, tissue under the skin in the palm of your hand gets thicker and shorter. This can cause your fingers to bend in toward your palm. Or it may only affect the palm. If it gets worse, it may be hard to use your hands.

The cause of Dupuytren's isn't known. But some things can increase your risk. If you have relatives who have it, you may be more likely to have it. Males, smokers, or those older than 50 are also at more risk. Having diabetes or alcohol use disorder can increase your risk as well.