What is Dupuytren’s Disease?

What is Dupuytren’s disease, and can it self-heal?

Dupuytren's disease is a genetic hand problem in which the deep tissue below the skin makes excess collagen and fibrin. Dupuytren's disease self-heals in about 12% of cases. DCI works to increase this ability of the tissue to self-heal. Simply stated, Dupuytren’s disease is the beginning phase of Dupuytren’s contracture. These two slightly different names indicate two distinct stages of the same progressive hand problem.

Dupuytren’s disease is a progressive genetic hand problem in which the connective tissue layer of the palm produces excess collagen and fibrin. This extra collagen causes an area of the palm near the base of one or more fingers to thicken and become less flexible. Typically, Dupuytren’s disease first appears on the surface as a small nodule or lump in the palm.  It is often mistaken for a small blister or callus. At this early stage, the area can also form small wrinkles, dimples or pits.

Dupuytren’s contracture is the later or end stage when Dupuytren’s disease becomes a larger, more disruptive and invasive problem. During this contracture stage, the growing mass of collagen and fibrin develops a cord of dense tissue. The cord extends up and attaches to the finger closest to it. All the while, the finger cord is also thickening and contracting. This causes the cord to pull the finger down toward the palm.  It can take many months or years for this slow and gradual process to occur. The contraction process can be continuous, or it can completely stall for months or years at a time. It can even stop, start and stop again a few times before it picks up speed.

Dupuytren’s disease self-heals – spontaneous recovery 

The medical profession says there is no cure for Dupuytren’s disease. But that is not exactly true. When they say there is no cure they mean, “there is no prescription drug that cures Dupuytren, in the way that penicillin cures an infection.”

The truth is, there is a cure for Dupuytren. An undetermined percentage of people self-cure their Dupuytren without help from anyone. It happens naturally, like mending a broken bone. This is the way the body is supposed to work. Life is full of miracles, and self-healing is one of them.

The body can, and does, spontaneously repair Dupuytren disease like it heals so many other small and large health problems. Unfortunately, this does not happen every time, or in every situation.

Self-healing of Dupuytren’s disease

Sometimes the healing process needs some help to work better.  For example, every good doctor will tell a patient with a broken bone to drink extra milk, take vitamin D, wear a cast, and avoid stressing the limb.  These simple strategies help the body heal a broken bone better. The same for taking extra iron for anemia, and extra rest and vitamin C for a cold. DCI applies the same logic for designing Dupuytren’s disease treatment plans.

Based on the simple observation that some people self-heal their Dupuytren problem early, the Dupuytren’s Contracture Institute developed a natural treatment strategy to help people do a better job healing their Dupuytren disease.

As a result, people who closely follow the DCI treatment strategy early can do rather well. We hear from many people who use our large treatment plan.  Of these, 8-10 people report moderate to marked reduction of their Dupuytren, for every one report of failure. We find that the larger the treatment plan, and the better a person follows DCI suggestions, the better the Dupuytren self-heals. For information about DCI treatment plans.

>> Testimonials from Dupuytren Contracture Institute

Keeping Dupuytren’s disease self-healing a secret

However, even though Dupuytren self-healing happens, medical writers never actually use the term “self-heal,” “self-correct;” or any term close to it. On top of that, the usual term medical writers use  instead for self-healing of Dupuytren disease is to say it “goes away.”

For example, the NIH National Library of Medicine (MedlinePlus.gov) admits “Dupuytren’s nodules…occasionally even go away without treatment…”  Exactly what does “go away” mean?  They do not say. The world-famous Cleveland Clinic states, “…some people’s nodules go away on their own.”  They never explain anything about how or why it would go away.  WebMD.com tells readers that palm nodules, “…may go away on their own in a small number of patients…”  The Dupuytren Research Group (Dupuytrens.org) says, “Some Dupuytren’s nodules go away without any treatment.”

Yes, the nodules go away on their own because the body can heal Dupuytren’s disease!

How often does Dupuytren’s disease go away on its own?

Even so, in these simple one-line statements about Dupuytren’s disease self-healing, something is missing.  The reader has no idea how often the body is able to self-correct or naturally eliminate Dupuytren’s disease. In these four quotes – and all the others on the internet – the reader is not told if self-healing is fairly common or is it rare. Does Dupuytren spontaneous recovery happen once in a hundred cases, or once in a million?

It is almost as though medical writers do not want to admit the body can self-heal Dupuytren’s disease.  Like they want to say as little as possible about Dupuytren disease self-healing. As a result, people believe they have only two treatment choices for their hand nodule: drugs and surgery.

Self-healing far more common than people told   

For the most part, internet readers are not told how common or uncommon it is for the Dupuytren nodule to spontaneously self-heal.

However, in a 2005, a Journal of Hand Surgery (JHS) report and follow-up study appeared discussing the progression of Dupuytren nodules over a span of 6-15 years. It covered all the usual data of history, genetic tendency, physical findings and surgeries of 59 people in the middle and later stages of Dupuytren disease. This report is unique and important because it clearly states how many times Dupuytren disease self-repair happened within this group of 59 people. This is the only time DCI has found an author who placed a number on the frequency of Dupuytren’s self-healing.

Near the bottom of the report, the author states that 12% of the 59 people (seven people) had spontaneous remission or self-0helaing of Dupuytren palm lumps.  Even though these 59 people had Dupuytren’s disease that was bad enough that they saw a specialist about their hands, for 12% of them, the Dupuytren’s nodule resolved by self-repair or spontaneous healing.

Is 12% a small or large number?

Perhaps the 12% self-correction is not an impressive number to some readers. Some might even think 12% is a small number of people. Actually, that 12% number is huge. With this number we gain important insight into the course and behavior of Dupuytren disease.

This number represents the Dupuytren disease cases that were bad enough to be in a doctor’s office for evaluation and treatment, yet somehow self-healed.  If cases of DD that are bad enough to be seen by a doctor can clear up without help, what about minor and early cases of DD?  When DD is not much more than a curious little bump, can it also clear up by self-healing?  Of course!  And probably at a much higher percentage than just 12%.  When the palm lumps are smaller, softer and less well developed, would be a much better time and opportunity for this kind of self-repair to occur.

The average percentage of Dupuytren disease that self-heals is not knowable. There is no good way to collect this kind of information.  No one goes to a hand specialist to report a small palm lump that is gone.  Who would spend the time and money to see a doctor to report a tiny problem that healed itself and is not there?  For this reason, the number of early Dupuytren’s disease hands that self-correct can only be estimated.  Perhaps, 25-50%?  Anyone’s guess.

Regardless, it is important to know that Dupuytren disease self-cures happen.  Everyone with a Dupuytren’s nodule has some potential to heal it, especially in the early stages, and probably less so in the later stages.

>> How to start Dupuytren treatment with Alternative Medicine

Reasonable assumptions

We have seen that 12% of 59 people self-healed their Dupuytren’s disease during the middle and later stages. This happened without the benefit of any nutritional, physical therapy, stretching or enzyme treatment.  It happened spontaneously.  It seems reasonable to assume that if these same 59 people received adequate nutritional, physical therapy, stretching and enzyme treatment assistance during the middle and later stages of Dupuytren’s disease, the percentage of people who self-healed would have been larger.

Further, it seems reasonable that if 12% self-healed in the middle and later stages of DD, an even larger percent self-healed in the early stage. This would likely happen because in the early stage of Dupuytren disease the connective tissue mass in the palm is softer, smaller and less infiltrated with excess collagen and fibrin. As an example, it is reasonable to assume that a greater percentage of people self-heal their minor cold or sniffles while the problem is smaller, than when it gets worse and becomes pneumonia.

Lastly, DCI treatment verifies that people self-heal Dupuytren disease.  When people use the large DCI treatment plan, good things can happen. DCI receives 8-10 reports of moderate to marked improvement, even elimination, of the palm lump, for every one report of failure.

>> How to start Dupuytren treatment with Alternative Medicine

 

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.

>> Testimonials from Dupuytren Contracture Institute

>> How to start Dupuytren treatment with Alternative Medicine

>> Dupuytren Contracture Treatment – FAQs

 

Do you know anything about santyl ointment?

do you know anything about santyl ointment?
thanks,
larry

 

Greetings Larry,

Santyl ointment is a petroleum based product containing collagenase that is formulated to debride (remove) necrotic (dead) tissue cells from burns, ulcers, gangrenous tissue and poorly healing wounds.   Much like maggots  were once (and currently on occasion still are) applied to selectively remove the dead tissue of a poorly responding wound to promote healing, the collagenase of santyl ointment is also used for this specific purpose.

I suppose it is because of the way this collagenase ointment is formulated that it is to be applied specifically only to dead tissue, and not healthy or living tissue.  This makes its use for Dupuytren treatment contraindicated, and is likely the reason it does not have FDA approval for Dupuytren use.  This is probably also the reason that the drug manufacturers have not attempted to market it as a Dupuytren disease treatment.

When it is applied carelessly or accidentally to normal tissue a reaction occurs in which localized inflammation develops, suggesting that the collagen of normal tissue is attacked by the collagenase of santyl ointment.   Given the nature of collagenase to indiscriminately disrupt collagen, prolonged use for Dupuytren cord or nodule treatment would result eventually result in an ulcer that would not heal because of the presence of collagenase.  For this reason the manufacturer of santyl ointment is careful to emphasize that it should only be applied to the dead tissue of a burn, ulcer, gangrene or poorly healing wound, not intact and viable skin.

Lastly, I have have checked the molecular weight of collagenase and I believe it is too large for it to be carried by DMSO through the tissue. TRH

 

 

 

 

 


Is Dupuytren’s Contracture in the arthritis family?

Dr. Herazy,

Is Dupuytren’s Contracture in the arthritis family? And, if it is, what vitamins should I be taking for the swelling and losing the use of my last two fingers.

Thank you.

Greetings,

No, Dupuytren contracture is not in the arthritis family.  By definition, an arthritis is an inflammation of a joint.  Joint inflammation and swelling are not the primary element of the problem of the excess collagen formation in the palm of the hand known as Dupuytren contracture.  While the joints of the finger might eventually become affected, it is a secondary complication.

Which vitamins to take is discussed at length on the DCI website.   You can begin your reading at Introduction to Natural Dupuytren Treatment.    The process of determining exactly which vitamins, minerals, enzymes or other external therapies to use is also discussed in that same section.   It is determined by monitoring the condition of the size, shape, density and adherence of the Dupuytren nodule to the deep fascia of the palm as you experiment with the therapies available on the DCI website.   TRH