Dupuytren's Contracture: Emerging Insight Into a Viking Disease

Nunn, Adam; Schreuder, F.

doi:10.1142/s0218810414300058

Cited by 14 publications

(13 citation statements)

References 50 publications

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“…Presumably, the primary diagnosis in these patients causes changes at the molecular level that make their fibroblasts susceptible to triggers that initiate dedifferentiation into myofibroblasts, which, consequently, stimulates an imbalance in collagen turnover that leads to nodules, cords, and contractures. 13) Notable distinctions in the presentation of Dupuytren's disease have been observed between diabetic and non-diabetic patients, namely that patients with DM tend to have a milder form of the disease, more commonly have involvement of the middle and ring fingers (as opposed to the ring and small fingers, which is more typical for non-diabetics), and may develop Dupuytren's disease through a different pathophysiologic process. 14,15) Most of the extant literature evaluates the prevalence of Dupuytren's disease among patients with DM, but does not examine the surgical outcomes in this patient population.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Outcomes Following Fasciectomy for Dupuytren’s Disease in Diabetic and Non-Diabetic Patients

Melamed

Beutel

Goldstein

et al. 2017

J Hand Surg Asian-Pac Vol

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Background: The aim of this study was to compare clinical outcomes, and identify predictors thereof, after fasciectomy for Dupuytren’s disease in a series of diabetic patients compared with non-diabetic patients. Methods: Thirty-eight patients were examined following partial palmar and/or digital fasciectomy for Dupuytren’s disease (11 diabetics, 27 non-diabetics). Each patient was assessed for degree of pre- and post-operative flexion contractures at the MCP and PIP joints, post-operative Patient Evaluation Measure (PEM) total score, post-operative grip strength, limited joint mobility (LJM), recurrence, extension, and a composite outcomes score based upon grip strength and the degree of joint contractures. All measurements in the diabetic cohort were compared to those in the non-diabetic group, and a logistic regression analysis was performed to identify the predictive value of several variables on outcomes. Results: Complication rates between the two groups were statistically similar (p = 0.67). There were no significant differences in pre-operative MCP (p = 0.69), post-operative MCP (p = 0.39), pre-operative PIP (p = 0.40), or post-operative PIP (p = 0.13) joint flexion contractures between the two groups. Additionally, there was no significant difference in extension (p = 0.35) or recurrence (p~1) rates, post-operative grip strengths (p = 0.64), or PEM total scores (p = 0.32). However, the rate of LJM was significantly higher in the diabetic population (p = 0.02). Both female gender (p = 0.01) and a non-smoking status (p = 0.04) were found to be predictive of better outcomes following fasciectomy. Diabetes was not found to be an independent predictor of outcome (p = 0.73). Conclusions: Clinical results after fasciectomy for Dupuytren’s disease in diabetic patients are not different from results obtained in non-diabetic patients. Diabetes is not independently predictive of surgical outcomes. Female gender and non-smoking status are independent predictors of a better outcome following fasciectomy.

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Section: Discussionmentioning

confidence: 99%

Predictors of Outcomes Following Fasciectomy for Dupuytren’s Disease in Diabetic and Non-Diabetic Patients

Melamed

Beutel

Goldstein

et al. 2017

J Hand Surg Asian-Pac Vol

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“…Dupuytren disease most commonly affects men of northern European white descent 21 . A study of a 5‐generation Swedish family suggested that Dupuytren disease is inherited as an autosomal dominant condition with incomplete penetrance 22 .…”

Section: Genetic Links For Development Of Peyronie’s Disease and Dupumentioning

confidence: 99%

Fibroproliferative disorders and diabetes: Understanding the pathophysiologic relationship between Peyronie’s disease, Dupuytren disease and diabetes

Gelbard

Rosenbloom

2020

Endocrino Diabet & Metabol

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Introduction Fibrosis is characterized by dysregulation and accumulation of extracellular matrix. Peyronie's disease and Dupuytren disease are fibroproliferative disorders of the tunica albuginea of the penis and fascia of the hand, respectively. Chronic hyperglycaemia due to diabetes mellitus can also lead to tissue injury and fibrosis. A meta‐analysis has shown a relationship between Dupuytren disease and diabetes (overall odds ratio, 3.1; 95% confidence interval, 2.7‐3.5). This review explores commonalities in the pathogenesis of Peyronie's disease, Dupuytren disease and diabetes. Methods A search of the PubMed database was conducted using the search terms “diabetes” AND “Peyronie's disease”; and “diabetes” AND “Dupuytren.” Results Genome‐wide association and gene expression studies conducted with tissue from people with Peyronie's disease or Dupuytren disease identified signalling pathways associated with wingless‐type mammary‐tumour virus integration site signalling, extracellular matrix modulation and inflammation. Biochemical studies confirmed the importance of these pathways in the pathogenesis of fibrosis with Peyronie's disease and Dupuytren disease. Dysregulation of matrix metalloproteinase activity associated with extracellular matrix breakdown was implicated in fibroproliferative complications of diabetes and in the aetiology of Peyronie's disease and Dupuytren disease. A notable percentage of people with diabetes have comorbid Peyronie's disease and/or Dupuytren disease. Conclusions Studies have not been performed to identify fibroproliferative pathways that all 3 conditions might have in common, but data suggest that common pathways are involved in the fibroproliferative processes of Peyronie's disease, Dupuytren disease, and diabetes.

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“…Several studies have implicated the TGFβ and WNT pathways as drivers of fibrosis in DD (reviewed in [15–17]). Expression analyses in DD (by e.g.…”

Section: Molecular and Cellular Alterations In Dd Degenerationmentioning

confidence: 99%

Connective Tissue Degeneration: Mechanisms of Palmar Fascia Degeneration (Dupuytren’s Disease)

et al. 2016

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Dupuytren’s disease is a connective tissue disorder of the hand causing excessive palmar fascial fibrosis with associated finger contracture and disability. The aetiology of the disease is heterogeneous, with both genetic and environmental components. The connective tissue is abnormally infiltrated by myofibroblasts that deposit collagen and other extracellular matrix proteins. We describe the clinical profile of Dupuytren’s disease along with current therapeutic schemes. Recent findings on molecular and cellular parameters that are dysregulated in Dupuytren’s disease, which may contribute to the onset of the disease, and the role of resident inflammation promoting fibrosis, are highlighted. We review recent literature focusing on non-myofibroblast cell types (stem cell-like cells), their pro-inflammatory and pro-fibrotic role that may account for abnormal wound healing response.

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Dupuytren's Contracture: Emerging Insight Into a Viking Disease

Cited by 14 publications

References 50 publications

Predictors of Outcomes Following Fasciectomy for Dupuytren’s Disease in Diabetic and Non-Diabetic Patients

Predictors of Outcomes Following Fasciectomy for Dupuytren’s Disease in Diabetic and Non-Diabetic Patients

Fibroproliferative disorders and diabetes: Understanding the pathophysiologic relationship between Peyronie’s disease, Dupuytren disease and diabetes

Connective Tissue Degeneration: Mechanisms of Palmar Fascia Degeneration (Dupuytren’s Disease)

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