Dupuytren’s contracture is a condition where the connective tissue beneath the skin of the palm thickens and tightens over time. This thickening causes the fingers, often the ring and little fingers, to be pulled inward toward the palm, making it difficult or impossible to straighten them fully. The process is gradual and usually painless, which can delay people from noticing or seeking treatment early.
The root cause of Dupuytren’s contracture is not fully understood, but it involves an abnormal buildup of collagen, a protein that provides structure and strength to connective tissues. In this condition, the collagen in the palmar fascia—the fibrous layer under the skin of the palm—starts to multiply excessively and form thick cords and nodules. These cords act like tight ropes that pull the fingers inward, leading to the characteristic contracture.
Several factors are known to increase the risk of developing Dupuytren’s contracture:
– **Age:** It most commonly affects people over 40 years old, with risk increasing as people get older.
– **Gender:** Men are more frequently affected than women, often with more severe symptoms.
– **Genetics:** There is a strong hereditary component. The condition tends to run in families, especially among people of Northern European descent.
– **Lifestyle factors:** Smoking and excessive alcohol consumption have been linked to a higher risk, possibly because they affect blood flow and tissue health.
– **Other health conditions:** Some studies suggest a connection with diabetes and epilepsy, though the exact relationship is unclear.
The condition is not caused by injury or infection, nor is it contagious. Instead, it appears to be a complex interplay of genetic predisposition and environmental or lifestyle factors that trigger the abnormal collagen production in the palm.
Early signs often include small, firm lumps or nodules in the palm near the base of the fingers. These nodules may feel like tiny pebbles under the skin and can sometimes be tender. Over time, these nodules develop into thick cords that extend toward the fingers. As the cords tighten, they pull the fingers inward, causing difficulty in straightening them and impairing hand function.
Because Dupuytren’s contracture progresses slowly and is usually painless, many people do not seek medical advice until the finger contracture significantly limits hand use. This delay can make treatment more challenging.
In summary, Dupuytren’s contracture is caused by an abnormal thickening and tightening of the connective tissue in the palm due to excessive collagen buildup. While the exact triggers remain unknown, age, male gender, family history, and certain lifestyle factors increase the likelihood of developing this condition. It begins with nodules in the palm and progresses to cords that pull the fingers inward, gradually restricting hand movement.
