Question:
Several years ago, I heard that former Prime Minister Margaret
Thatcher was going to undergo an operation on her hand for a rare
condition that seems to afflict only persons from the British Isles.
The way in which it was described piqued my interest because it
resembles a problem that I am having, and, coincidentally, I have
English genes in my DNA. My problem is that I cannot, no matter how
hard I try, find the proper search terminology to learn about this
condition. Can anybody help? Thank you.


Answer:
Hey Dzhonz, how are you doing? Dupuytren disease is a
fibroproliferative disorder of unclear etiology and pathogenesis. It
is a disease that occurs primarily in men with Celtic ancestry. The
male-to-female ratio is 5:1 and one third of patients have a positive
family history. Usually, both hands are involved, with unilateral
disease an uncommon variant. Dupuytren disease is not an
etiologically uniform disease. Abnormal chromosomal patterns
(mosaicism) may be the cause of a fundamental abnormality in
fibrogenesis. Dupuytren disease may be a sequela of long-term
phenobarbitone administration. A low incidence is found prior to the
use of the drug. Chronic pulmonary disease is associated.
Alcoholism, similarly to patients with diabetes, actual contracture is
rare. Trauma, recurrent microtrauma has been demonstrated to be
related, as have unrelated injuries or wounds. Knuckle pads (or Garrod
nodes), plantar fibromatosis (Lederhose disease), Peyronie disease:
Because these often are observed in association, the term Dupuytren
disease is used rather than contracture. Incision or excision of
the diseased fascia is the only available treatment to correct joint
contracture. However, surgery does not cure the disease. Famous
sufferers of Dupuytren's Disease are former U.S. President Ronald
Reagan and former Prime Minister Margaret Thatcher. For additional
researhc on Diseases & Conditions/Dupuytrens Disease, please visit
Prescription Dispensing Laboratories (PDLABS). Best
wishes,


Answer:
Dupuytren's does not just affect people in the British Isles.
Dupuytren's disease is a thickening and shrinking of the layer of
flesh just under the skin of the palm. It can cause lumps or dimples
in the skin of the palm, and can draw the fingers down into a bent
position. There is a layer of tissue, called fascia, under the skin of
the palm which helps keep the the skin from sliding around when you
grip things. In some people, this tissue shrinks, and pulls on the
skin and on the fingers. The ring and the small fingers are affected
more often than the others. The problem appears to be inherited,
and usually begins in adulthood for no clear reason. It is painless
and benign, but unpredictable - some people will only have a lump,
others a very difficult problem with severely bent fingers. For a
severe problem, a therapist may be able to make a custom splint or
brace to stretch the fingers out a little more straight. If surgery
can't be done, this may help regain some movement of the fingers, but
requires using the splint every day. This type of program may also
help right before surgery, to make the surgery less complicated and
more safe. After surgery, a therapy program of massage, wound
care, exercises and night time splinting is important to get the best
possible result and prevent recurrence. It is often helpful to wear a
splint while sleeping for several months after surgery. Most people
who have had surgery for Dupuytren's feel that they made the right
choice to have surgery. However, most people who have surgery for
Dupuytren's contracture will have similar problems later on - either
developing elsewhere in the hand or coming back in the area of
previous surgery. Dupuytren's is a chronic, recurrent disease. If you
choose not to treat this condition, it will not get better on its own.