What you need to know about Dupuytren’s disease
The Palm Beach Post’s “Ask the Expert” column features Michelle G. Carlson, MD, hand and upper extremity surgeon at HSS Florida, discussing the causes and treatment options for Dupuytren’s disease.
Dr. Carlson explained Dupuytren’s disease forms scars in your palm for no reason, typically beginning in your 50s or 60s. Often this takes shape as a lump or cord in the palm or fingers. Dupuytren’s disease also occurs in the soles of the feet or alongside Peyronie’s disease. It is a genetic condition, however your parents or children will not necessarily have it. It is more common in men and people of Nordic descent. When it occurs in women, they more commonly have a relative with the disease.
Cords can cause the fingers to contract, preventing a person from straightening them. If there is no contracture, treatment is usually not necessary. Once contracture starts, there are several options for treatment.
According to Dr. Carlson, surgery is the gold standard and involves removing all diseased scar tissue. This allows the finger joints to straighten and has a 5% chance of requiring another procedure within five years. Collagenase clostridium is injectable medication that dissolves collagen, which makes up the cords.
Needle aponeurotomy is a procedure in which the surgeon uses a needle to cut the cords and extend the finger. This similarly does not require surgery but carries a small risk of injuring a nerve in the finger and has a higher recurrence rate. It is better to treat contracture once it begins instead of waiting for it to be severe. If you think you may have Dupuytren’s, Dr. Carlson advised to see a healthcare provider to determine if treatment is needed.
This article appeared in the print edition on February 28, 2021.