How does a Dupuytren nodule form on the palm?
Dupuytren nodules and cords are different
Dupuytren nodule formation, the first sign of Dupuytren contracture, usually affects males 50 years and over, especially those of northern European descent. Although the size and shape are variable they are usually range in size from a dime to a quarter, although they can be smaller and larger than this. Typically a person will first notice a small bump or lump on the palm that increases over time.
Dupuytren nodules are different from other connective tissues of the palm at the cellular level in two ways: there is an increased activity and growth of two types of connective tissue cells called the fibroblast and myofibroblast; there is greater production of a connective tissue protein called collagen. As these fibroblasts and collagen are laid down in the palm of the hand, it causes first nodule formation, and later Dupuytren cord formation. The presence of these two structures is associated with progressive thickening, puckering and adherence to the skin, resulting in palmar fascial contractures and later flexion of the involved finger(s) under the skin of the palm (specifically, the pre-tendinous bands of the palmar fascia).
Dupuytren nodules are different from Dupuytren cords at the cellular level in that there are fewer myofibroblasts and fibroblasts in the cord, and they are irregularly scattered in all directions in the nodules they are in a distinctly parallel pattern in the cord.
The most common site for these palm lumps is at the base of the 4th (ring) and 5th little) fingers. The Dupuytren nodule at first can resemble a common callus and is often painless, unless touched; occasionally the pain is more significant and lasts for some long while.
Dupuytren lump on the palm
What triggers the Dupuytren lump on the palm nodules to form is still a medical mystery, but seems to be related to liver disease, smoking, trauma and diabetes amongst a few lesser factors.
As the palmar tissue slowly thickens and tightens over months to years, it can develop into Dupuytren cords that flex the involved finger(s) down toward the palm of the hand. In severe cases the Dupuytren nodules and cords can cause such marked finger(s) flexion that hand function is compromised for common activities of daily living (personal hygiene, dressing, opening a door, putting the hand into a pocket, etc.), so that the individual is functionally disabled.
The progress of Dupuytren nodule development is typically slow, unpredictable and sporadic, without detectible exciting factors. As the disease progresses over time, the thickened and dense tissue infiltrates between and around normal tissue structures (tendons, ligaments, nerves, blood vessels).
While the medical profession (surgeons) commonly state that the primary treatment option for Dupuytren contracture is surgery to remove the nodule and cord formation, as well as contracted tissue around involved joints, a small but growing segment of the medical profession agrees that non-drug and non-surgical treatment is an effective option that should be attempted before resorting to the surgical route.
For more information how to reverse and eliminate, or at least reduce, Dupuytren nodules and cords see natural Dupuytren treatment.