Dupuytren'S Contracture; Increased Cellularity — Proliferation, is There Equality?

Background: Dupuytren's disease is a chronic inflammatory process which causes contractures of the fingers by shortening and thickening the palmar fascia. During the proliferative phase, fibroblasts transform into myofibroblasts apparently under the influence of several different factors. The disease usually develops slowly, but in some patients it tends to develop aggressively. The pathogenesis of Dupuytren's disease remains unsolved. In this study, we analyzed some histological characteristics that seem to predict rapid recurrence. Material and Methods: 21 patients were divided into two groups. In 11 patients the disease was classified as aggressive because it had recurred within two years after an operation. In 10 cases it was non-aggressive, as no recurrence had been seen. Five control samples were taken from healthy palmar aponeurosis. The differences in cellularity, collagen, Ki-67, MSA, alpha-SMA and tenascin between the specimens were analyzed using immunohistochemistry. Results: Alpha-SMA and Ki-67 were present more often in the aggressive specimens. Immunohistochemical stainings for macrophages and lymphocytes were negative. Conclusion: There may be differences in the histology and/or immunohistochemical appearance of pathological palmar connective tissue cords in aggressive and normal Dupuytren's disease. Further studies are needed to elucidate the pathogenesis of this disease.

Download Full-text

Scanning Electron Microscopy of Palmar Fascia in Dupuytren’s Disease of Advanced Stage

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2019-25-2-150-156 ◽

2019 ◽

Vol 25 (2) ◽

pp. 150-156

Author(s):

N. A. Shchudlo ◽

T. A. Stupina ◽

M. M. Shchudlo

Keyword(s):

Dupuytren’S Disease ◽

Palmar Fascia ◽

Dupuytren's Disease ◽

Palmar Aponeurosis ◽

Medical Histories ◽

Fibers Orientation ◽

Disease Stages ◽

Grade Iii ◽

Scanning Electron

Relevance. Dupuytren’s disease (palmar fascial fibromatosis) affects primarily palmar and digital fascia and results in progressive wrist deformity in many patients and often with bilateral involvement. Absence of corresponding data on the patients with severe wrist deformities along with their treatment issues is the ground for targeted research of pathomorphology of advanced disease stages.Purpose of the study — to identify features of ultrastructure of fibromatosis nodules and bands in palmar aponeurosis of patients with Dupuytren’s disease of grade III-IV.Materials and Methods. The authors analyzed medical histories and surgical material of 20 patients aging 42–77 years. Segments from medial portion of pretendinous cord of IV digit were cut for examination under scanning electron microscope (JSM-840, Jeol, Japan).Results. Irrespective of disease history (from 1 to 20 years) fibrbous-fibrillar network and fine cylindrical collagen fibers prevailed in nodules of pretendinous cord which formed semicircular and circular end coils. Empty lacunae, functionally active fibroblasts and close cellular pairs were observed in nodules. Bands differed from nodules by lesser cellularity and less content of fine fibers, orientation of thick fibers mainly along one axis, straightening segments of undulated twisting and separate twisted and tightly interwoven fiber fragments.Conclusion. In Dupuytren’s disease of grade III-IV nodules maintain the role of active contractile centers. Despite relatively small cellularity of pathologically altered tissues there is a potential for progressing, propagation and recurrence of fibromatosis.

Download Full-text

Epidermal Growth Factor Receptor (EGF-R) in Dupuytren’s Disease

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2005.06.008 ◽

2005 ◽

Vol 30 (6) ◽

pp. 570-573 ◽

Cited By ~ 10

Author(s):

K. AUGOFF ◽

R. TABOłA ◽

J. KULA ◽

J. GOSK ◽

R. RUTOWSKI

Keyword(s):

Epidermal Growth Factor Receptor ◽

Growth Factor ◽

Epidermal Growth Factor ◽

Growth Factor Receptor ◽

High Ratio ◽

Dupuytren’S Disease ◽

Palmar Fascia ◽

Dupuytren's Disease ◽

Palmar Aponeurosis ◽

Epidermal Growth

The aim of this paper was to examine participation of the epidermal growth factor receptor (EGF-R) signal pathway in the pathogenesis of Dupuytren’s disease. The study showed changes in the ratio of membrane EGF-R to its intracellular level during the different clinical stages of Dupuytren’s contracture progression. Our observations of a high ratio of surface to intracellular EGF-R in the palmar aponeurosis of patients with second degree of Dupuytren’s disease (Iselin’s classification), which was significantly higher than this ratio in control palmar fascia ( P = 0.022), would suggest that EGF-R has a role in the involutional phase of the disease.

Download Full-text

Type-1 Collagen differentially alters β-catenin accumulation in primary Dupuytren's Disease cord and adjacent palmar fascia cells

BMC Musculoskeletal Disorders ◽

10.1186/1471-2474-10-72 ◽

2009 ◽

Vol 10 (1) ◽

Cited By ~ 16

Author(s):

Linda Vi ◽

Anna Njarlangattil ◽

Yan Wu ◽

Bing Siang Gan ◽

David B O'Gorman

Keyword(s):

Dupuytren’S Disease ◽

Palmar Fascia ◽

Dupuytren's Disease

Download Full-text

An effectiveness evaluation of the palmar fascia irradiation of patients suffering from Dupuytren’s disease

Nowotwory Journal of Oncology ◽

10.5603/njo.2017.0027 ◽

2017 ◽

Vol 67 (3) ◽

pp. 162-167 ◽

Cited By ~ 1

Author(s):

Tomasz Latusek ◽

Leszek Miszczyk ◽

Grzegorz Gierlach ◽

Piotr Zając

Keyword(s):

Dupuytren’S Disease ◽

Effectiveness Evaluation ◽

Palmar Fascia ◽

Dupuytren's Disease

Download Full-text

Periostin differentially induces proliferation, contraction and apoptosis of primary Dupuytren's disease and adjacent palmar fascia cells

Experimental Cell Research ◽

10.1016/j.yexcr.2009.07.015 ◽

2009 ◽

Vol 315 (20) ◽

pp. 3574-3586 ◽

Cited By ~ 43

Author(s):

Linda Vi ◽

Lucy Feng ◽

Rebecca D. Zhu ◽

Yan Wu ◽

Latha Satish ◽

...

Keyword(s):

Dupuytren’S Disease ◽

Palmar Fascia ◽

Dupuytren's Disease

Download Full-text

Dupuytren’s disease

10.1093/med/9780199550647.003.006007 ◽

2011 ◽

Author(s):

Peter Burge

Keyword(s):

Surgical Treatment ◽

Steroid Injection ◽

Treatment Options ◽

Genetic Component ◽

Dupuytren’S Disease ◽

Palmar Fascia ◽

Dupuytren's Disease ◽

Collagenase Injection ◽

Operative Complications ◽

Non Surgical Treatment

♦ Dupuytren’s disease is characterised by contracture of a finger resulting from thickening and shortening of the palmar fascia♦ A genetic component to the aetiology is apparent, smoking, alcohol and diabetes can increase the risk♦ The pathogenesis of Dupuytren’s disease remains elusive♦ Non-surgical treatment options include splintage, steroid injection and collagenase injection♦ Surgery cannot cure the disease but can straighten bent digits and minimize recurrence♦ Operative methods can be considered with regards to incision, management of the diseased fascia and closure techniques♦ Operative complications include injury of digital nerves and arteries

Download Full-text

BREAKING THE RULES: DUPUYTREN'S DISEASE UNDER SKOOG'S FIBRES

Hand Surgery ◽

10.1142/s0218810413720155 ◽

2013 ◽

Vol 18 (02) ◽

pp. 255-256 ◽

Cited By ~ 1

Author(s):

Christopher F. Munson ◽

Dominique Davidson ◽

Prakash Lohana

Keyword(s):

Disease Process ◽

Conventional Wisdom ◽

Dupuytren’S Disease ◽

Transverse Ligament ◽

Dupuytren's Disease ◽

Palmar Aponeurosis

Skoog and others have concluded that the Skoog fibres, or transverse ligament of the palmar aponeurosis (TLPA), are never involved in the Dupuytren's disease process. Here we present a case in which this clearly occurs. Whilst for the vast majority of Dupuytren's cases the Skoog's fibres delineate the required deep extent of dissection for pretendinous cords, this case proves an exception, highlighting an occasional need to beware of accepting the conventional wisdom.

Download Full-text

Chemical analysis of palmar aponeurosis in Dupuytren's disease.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.34.1450 ◽

1986 ◽

Vol 34 (4) ◽

pp. 1450-1454

Author(s):

Hiroaki Takami ◽

Kuniichi Aso ◽

Kazunori Tomonari ◽

Shogo Masumi

Keyword(s):

Chemical Analysis ◽

Dupuytren’S Disease ◽

Dupuytren's Disease ◽

Palmar Aponeurosis

Download Full-text

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

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(91)90051-o ◽

1991 ◽

Vol 16 (3) ◽

pp. 267-271 ◽

Cited By ~ 30

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.

Download Full-text