Aetiology of Dupuytren's Contracture

Abstract

Dupuytren's contracture is a fascinating, deforming, fibrotic condition of the palmar fascia which has confounded clinicians and scientists for centuries. The aim of this paper is to place in perspective the longstanding associations of age, sex, race, hereditary factors, diabetes and alcohol consumption with the more recent novel investigations at the cellular level. In concert, the findings indicate that a number of factors may lead to the narrowing of palmar fascia microvessels, with localized ischaemia and oxygen free radical release. Oxygen free radicals are likely to damage the surrounding stroma, and stimulate fibroblast proliferation. Proliferating fibroblasts lay down collagen and contract in the lines of stress. The process is likely to encourage further microvessel ischaemia with a positive feedback effect that is consistent with the progressive nature of the condition.

A prospective study linked both alcohol and tobacco to Dupuytren's disease

“…Dupuytren's disease is known to mainly affect middle-aged and elderly Northern European males, and it has a strong genetic predisposition, presumably inherited as an autosomal dominant condition. It has also been linked to diseases and conditions such as non-insulin-dependent diabetes mellitus, epilepsy, arcus corneae (also known as arcus senilis), and hypercholesterolemia [1,2]. With respect to lifestyle factors, special attention has been paid to occupation, alcohol consumption, and cigarette smoking.…”

Induratio penis plastica

“…Ein gemeinsames Auftreten mit der Dupuytren-Kontraktur -in der Literatur mit 7-60% beschrieben [5,11,12,20,21] -sahen wir in unserem Patientengut bei elf Patienten (19%). In der Vergangenheit hatten sich 15 Patienten (26%) einer konservativen medikamentösen Therapie mit K-Paraaminobenzoat (Potaba ® ), Vitamin E und/oder Hyaluronidaseinjektionen unterzogen, ohne dass dabei eine Besserung ihrer Beschwerden erzielt werden konnte.…”

Role of the HLA System in the Pathogenesis of Dupuytren's Disease

“…This relates to the lack of DD precipitation in RA patients since these individuals often have a high intake of prostaglandin inhibitors [50] due to their role in immune regulation.…”