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Dupuytren's contracture

Dupuytren's (du-pwe-TRANZ) contracture is a hand deformity that usually develops slowly, over years. Dupuytren's contracture affects a layer of tissue that lies under the skin of your palm. Knots of tissue form under the skin — eventually forming a thick cord that can pull one or more of your fingers into a bent position.

Once this occurs, the fingers affected by Dupuytren's contracture 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 most commonly affects the ring finger and pinky, 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 Causes Risk factors Complications

Dupuytren's contracture typically progresses slowly, over years. Occasionally it can develop over weeks or months. In some people it progresses steadily, and in others it may start and stop.

Dupuytren's contracture usually begins as a thickening of the skin on the palm of your hand. As Dupuytren's contracture progresses, the skin on the palm of your hand may appear puckered or dimpled. A firm lump of tissue may form on your palm. This lump may 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 may extend up to your fingers. As these cords tighten, your fingers may be pulled toward your palm, sometimes severely.

The ring finger and pinky are most commonly affected, though the middle finger also may 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 than the other.

Doctors don't know what causes Dupuytren's contracture. Some researchers have speculated that it may be associated with an autoimmune reaction, where a person's immune system attacks its own body tissues. Dupuytren's often occurs in concert with conditions that cause contractures in other parts of the body, such as the feet or penis.

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.
  • Your 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.

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 experience much inconvenience or disability with fine activities such as writing. But as Dupuytren's contracture progresses, it can limit your ability to fully open your hand and make it difficult to grasp large objects or to get your hand into narrow places.

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