Dupuytren's disease and slang terms "Viking disease" or "Celtic hand), is a fixed flexion contracture of the hand due to a palmar fibromatosis, where the fingers bend towards the palm and cannot be fully extended. It is an inherited proliferative connective tissue disorder that involves the hand's palmar fascia. The ring finger and little finger are the fingers most commonly affected.
Symptoms: In Dupuytren's contracture, the palmar fascia within the hand becomes abnormally thick, which can cause the fingers to curl and can impair finger function. Patients often report pain, aching and itching. Dupuytren's disease often starts with nodules in the palm of the hand and it can extend to a cord in a finger.
Diagnosis: Treatment is indicated when the so-called table top test is positive. With this test, the patient places his hand on a table. If the hand lies completely flat on the table, the test is considered negative. If the hand cannot be placed completely flat on the table, leaving a space between the table and a part of the hand as big as the diameter of a ballpoint pen, the test is considered positive and surgery or other treatment may be indicated.
Treament: Treatment involves one or more different types of treatment with some hands needing repeated treatment. The main categories listed by the International Dupuytren Society in order of stage of disease are Radiation Therapy, Needle Aponeurotomy (NA), Collagenase Injection (Xiaflex) and Hand Surgery. Pathophysiology: The palmar fascia becomes abnormally thick due from a change of collagen type. Normally, the palmar fascia consists of collagen type I, but in Dupuytren sufferers, the collagen changes to collagen type III, which is significantly thicker than collagen type I.
Epidemology: Dupuytren's disease occurs more frequently in men than women and becomes symptomatic approximately 10 years earlier in the lives of men than in women. Dupuytren's disease has been associated with a number of other diseases including seizure disorders, alcoholism, diabetes mellitus, and cigarette smoking. There is conflicting evidence as to whether manual labor or HIV seropositivity increases the prevalence of the disorder.