Dupuytren’s Contracture: An Update of Biomolecular Aspects and Therapeutic Perspectives

2005 ◽  
Vol 30 (6) ◽  
pp. 557-562 ◽  
Author(s):  
A. CORDOVA ◽  
M. TRIPOLI ◽  
B. CORRADINO ◽  
P. NAPOLI ◽  
F. MOSCHELLA
Keyword(s):  
Extracellular Matrix ◽  
Surgical Excision ◽  
Dupuytren’S Contracture ◽  
Palmar Fascia ◽  
Dupuytren's Disease ◽  
The Real ◽  
Practical Applications ◽  
Dupuytren's Contracture ◽  
Palmar Fibromatosis

The so-called fibrogenic cytokines, able to induce the growth of fibroblasts and their differentiation into myofibroblasts and to stimulate their production of extracellular matrix, are involved in the genesis of Dupuytren’s contracture. Although many studies have been made of biomolecular aspects of palmar fibromatosis, practical applications from them are still far from imminent because of the real difficulty of blocking their action in vivo, even in a chronic, progressive lesion such as Dupuytren’s disease. Consequently, surgical excision of the palmar fascia still remains the treatment of choice.

An Investigation into the Role of Inflammatory Cells in Dupuytren’s Disease

1991 ◽  
Vol 16 (3) ◽  
pp. 267-271 ◽  
Author(s):  
J. G. ANDREW ◽  
S. M. ANDREW ◽  
A. ASH ◽  
B. TURNER
Keyword(s):  
Inflammatory Cells ◽  
Dupuytren’S Disease ◽  
Dupuytren’S Contracture ◽  
Palmar Fascia ◽  
Dupuytren's Disease ◽  
Dupuytren's Contracture ◽  
Microvascular Changes ◽  
Macrophage Marker ◽  
Fibrotic Diseases

An immunohistochemical study was performed on nodules excised from the palmar fascia of patients with Dupuytren’s contracture. In cellular nodules, antibodies to actin (used as a marker for myofibroblasts), desmin, vimentin, Mac 387 (a macrophage marker) and leucocyte common antigen were used. A correlation was demonstrated between the numbers of macrophages and the presence of myofibroblasts. The presence of myofibroblasts is generally considered to indicate the active stage of the disease. Inflammatory cells other than macrophages were largely absent from the nodules, although lymphocytes were frequent in the tissue around the nodules. Microvascular changes were prominent in the nodules and pericyte proliferation was observed around occluded capillaries. Release of growth factors from macrophages may be important in Dupuytren’s contracture, as is the case in other fibrotic diseases. The possible role of macrophages in the aetiology of Dupuytren’s disease is discussed.

A Rare Finding in Dupuytren’s Disease - Heterotopic Ossification

2020 ◽  
Vol 25 (04) ◽  
pp. 513-514
Author(s):  
Sebastian Hediger ◽  
Sylvia Höller ◽  
Konrad Mende
Keyword(s):  
Heterotopic Ossification ◽  
Dupuytren’S Disease ◽  
Dupuytren’S Contracture ◽  
Cartilaginous Tissue ◽  
Dupuytren's Disease ◽  
Rare Finding ◽  
Dupuytren's Contracture ◽  
Palmar Fibromatosis

We present the case of a severe and long-standing Dupuytren’s contracture where intraoperatively an ossified nodule was encountered within the diseased tissue. Histologically palmar fibromatosis in contact with cartilaginous tissue with central ossification could be confirmed, compatible with metaplasia. Our finding suggests that metaplastic activity inherent to longstanding, severely diseased Dupuytren’s tissue can lead to heterotopic ossification.

Dupuytren's Contracture and Microvessels

1981 ◽  
Vol 39 ◽  
pp. 470-471
Author(s):  
C. W. Klscher ◽  
D. Speer
Keyword(s):  
Hypertrophic Scar ◽  
Active Form ◽  
Scar Tissue ◽  
Vascular Supply ◽  
Fiber Bundles ◽  
Dupuytren’S Contracture ◽  
Palmar Fascia ◽  
Immune Disease ◽  
Dupuytren's Contracture ◽  
Longitudinal Fiber

Dupuytren's Contracture is a nodular proliferation of the longitudinal fiber bundles of palmar fascia with its attendant contraction. The factors attributed to its etiology have included trauma, diabetes, alcoholism, arthritis, and auto-immune disease. The tissue has been observed by electron microscopy and found to contain myofibroblasts.Dupuytren's Contracture constitutes a scar, and as such, excessive collagen can be observed, along with an active form of fibroblast.Previous studies of the hypertrophic scar have led us to propose that integral in the initiation and sustenance of scar tissue is a profusion of microvascular regeneration, much of which becomes and remains occluded producing a hypoxia which stimulates fibroblast synthesis. Thus, when considering a study of Dupuytren's Contracture, we predicted finding occluded microvessels at or near the fascial scarring focus.Three cases of Dupuytren's Contracture yielded similar specimens, which were fixed in Karnovskys fluid for 2 to 20 days. Upon removal of the contracture bands care was taken to include the contiguous fatty and areolar tissue which contain the vascular supply and to identify the junctional area between old and new fascia.

Palmar fibromatosis (Dupuytren's contracture)

1984 ◽  
Vol 405 (1) ◽  
pp. 41-53 ◽  
Author(s):  
H. Iwasaki ◽  
H. M�ller ◽  
H. J. Stutte ◽  
U. Brennscheidt
Keyword(s):  
Dupuytren’S Contracture ◽  
Dupuytren's Contracture ◽  
Palmar Fibromatosis

scholarly journals Dupuytren’s Contracture with Secondary Ulnar Neuropathy

2020 ◽  
Vol 11 (03) ◽  
pp. 481-483
Author(s):  
Chen Fei Ng
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Symptoms ◽  
Chronic Alcoholism ◽  
Ulnar Neuropathy ◽  
Dupuytren’S Disease ◽  
Dupuytren’S Contracture ◽  
Hand Trauma ◽  
Dupuytren's Disease ◽  
Dupuytren's Contracture ◽  
Patients With Diabetes

AbstractDupuytren’s disease is a progressive fibrotic condition of the hand. The underlying pathomechanism is not fully known. Dupuytren’s contracture can be seen in patients with diabetes mellitus, chronic alcoholism, smoking, or hand trauma. It is uncommon to affect the neurovascular supply causing clinical symptoms. We describe a patient with idiopathic Dupuytren’s disease complicated with bilateral ulnar neuropathies and highlight the importance of such rare treatable complication.

The Palmar Fascia after Treatment by the Continuous Extension Technique for Dupuytren’s Contracture

1994 ◽  
Vol 19 (4) ◽  
pp. 528-533 ◽  
Author(s):  
G. BRANDES ◽  
A. MESSINA ◽  
E. REALE
Keyword(s):  
Clinical Stage ◽  
Light And Electron Microscopy ◽  
Continuous Extension ◽  
Collagen Fibrils ◽  
Dupuytren’S Contracture ◽  
Palmar Fascia ◽  
Biosynthetic Activity ◽  
Dupuytren's Contracture ◽  
Uniform Diameter ◽  
External Forces

After complete elongation using the continuous extension technique the palmar fascia of four patients with Dupuytren’s contracture was examined by light and electron microscopy and compared with non-elongated samples from 20 patients at the same clinical stage of the disease. Nodules and cords were no longer clinically recognizable after extension. The tissue contained collagen fibrils of uniform diameter (about 50 nm), densely packed in fibres parallel to the stretching force. Fine filaments (presumably proteoglycans) formed a network which was intermingled with and periodically bound to the collagen fibrils. Fibroblasts and myofibroblasts with an high biosynthetic activity and oxytalan-like microfibrils were aligned along the collagen fibres. The results show that in Dupuytren’s disease the contracted palmar fascia reacts to external forces with neoformation and reorientation of all tissue components by myofibroblasts.

Langerhans Cells in Dupuytren’s Contracture

2001 ◽  
Vol 26 (4) ◽  
pp. 362-367 ◽  
Author(s):  
F. I. QURESHI ◽  
R. HORNIGOLD ◽  
J. D. SPENCER ◽  
S. M. HALL
Keyword(s):  
Immune System ◽  
Inflammatory Cytokines ◽  
Epidermal Cell ◽  
Langerhans Cells ◽  
Disease Process ◽  
Inflammatory Cells ◽  
Dupuytren’S Contracture ◽  
Palmar Fascia ◽  
Dupuytren's Contracture

We have examined biopsies of Dupuytren’s contracture palmar fascia, overlying subcutis and skin, and have correlated the distribution of gross macroscopic changes in the hand, mapped pre- and intraoperatively, with light microscopic immunohistochemical findings. We report increased numbers of S100 positive Langerhans cells (an epidermal cell of dendritic lineage) and CD45 positive cells, both in “nodules” and at dermo-epidermal junctions, in the biopsied tissues. This suggests that Langerhans cells migrate from the epidermis into Dupuytren’s contracture tissue, possibly in response to local changes in levels of inflammatory cytokines within the tissue. Our findings, together with other reports of increased numbers of dermal dendrocytes and inflammatory cells in Dupuytren’s contracture tissue, lend circumstantial support to the “extrinsic theory” of the pathogenesis of Dupuytren’s contracture. However, the earliest stages of the disease process have not been defined, and therefore the events which ultimately produce fibrosis in the palmar fascial complex in susceptible individuals could begin in the skin and/or within deeper tissues, especially where there is dysregulation of the immune system.

Boutonniere Deformity in Dupuytren’s Disease

1988 ◽  
Vol 13 (4) ◽  
pp. 379-382
Author(s):  
J. N. KUHLMANN ◽  
A. BOABIGHI ◽  
S. GUERO ◽  
M. MIMOUN ◽  
S. BAUX
Keyword(s):  
Dupuytren’S Disease ◽  
Dupuytren’S Contracture ◽  
Dupuytren's Disease ◽  
Dupuytren's Contracture ◽  
Complete Ablation ◽  
Boutonniere Deformity ◽  
Extensor Apparatus ◽  
Boutonnière Deformity

The boutonnière deformity in Dupuytren’s disease has been found to be due to fibrous contraction of the transverse retinacular ligament which anteriorly displaces the fibres of the extensor apparatus. Complete ablation of this ligament and liberation of the extensor apparatus arrows easy extension of the finger when operating on severe cases of Dupuytren’s contracture.

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