Dupuytren's disease, also known as Dupuytren's contracture, is a deforming fibroproliferative disorder of the hand that results in flexion contractures of the fingers. It causes a thickening of the fascial tissue beneath the skin in the palm of the hand which can slowly pull one or more fingers into a bent position. This fibrotic process occurring deep in the palm can interfere with function and causes problems performing everyday tasks.
Epidemiology
Global Dupuytren's Disease has a global prevalence but predominately affects those of Northern European descent. Studies have shown the highest rates occur in Scandinavian countries with prevalence as high as 30-60% in men over 60 years old in Norway. Lower but significant rates of 5-30% are seen in other Northern European populations as well as among those of British ancestry. Prevalence is much lower in Southern European, Asian, African and Native American populations. Males are affected about 3-4 times more often than females. Risk also increases significantly with age, with onset typically occurring between 50-70 years of age. Despite the association with European ancestry, global migration trends have seen an overall increase in cases being reported outside of endemic European regions in recent decades.
Genetic and Environmental Factors
The exact cause of Dupuytren's disease remains unknown but both genetic and environmental factors are thought to play a role. A positive family history is seen in around 30-75% of cases indicating a strong hereditary component, although the mode of inheritance is complex. Various gene loci have been associated with susceptibility but the disorder is considered to be polygenic in nature. Environmental triggers such as manual labor, hand trauma, alcohol consumption, smoking, diabetes and epilepsy have all been linked to increased risk. The higher prevalence seen in colder Northern latitudes has led to the hypothesis that repetitive microtrauma from vibration or temperature changes may also contribute.
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