Dupuytren Diathesis

Dupuytren diathesis is a severe form of the condition

Dupuytren contracture is a condition characterized by thickening and shortening of fibrous bands of deep tissue of the palm of the hand (palmar fascia) that result in a bump in the palm of the hand and finger contracture.   This soft tissue problem has never been classified into specific types or categories of involvement.  However, it does present in a wide variation from mild and slowly progressing contracture of a single finger, to severe and rapidly progressive involvement of several fingers of both hands.  A more severe form of Dupuytren contracture has been termed a Dupuytren diathesis.

Diathesis is a medical term that means a tendency toward a particular condition; so that a Dupuytren’s diathesis is a term that indicates such a strong tendency toward this problem that it displays more severe or aggressive signs and symptoms of Dupuytren’s contracture than average. This is so much so, that someone with Dupuytren diathesis will often have a higher rate of developing complications after surgery to correct the finger and hand contractures, and to re-develop finger and hand contractures within a year or two.

Dupuytren’s diathesis is the term that has come into recent use to indicate not a different type of Dupuytren contracture.  In this application a Dupuytren diathesis indicates a more aggressive or advanced degree or severity of the basic hand contracture problem and its likelihood to recur even after treated.  People with Dupuytren’s diathesis are much more likely to have ancestors with Dupuytren, and are more likely to pass the tendency for Dupuytren on to their children than people with a milder expression of Dupuytren.

Indicators of a Dupuytren diathesis

Dupuytren contracture has an unknown cause, but it is widely recognized that it is driven by strong heredity or genetic factors.  When these heredity factors are well developed the Dupuytren diathesis is displayed as:

  1. Experiencing more than one soft tissue problem in which extra soft tissue proliferation is an integral component of the problem: Dupuytren contracture of the palm; Garrod’s pads of the finger knuckles; Ledderhose of the feet; Peyronie disease of the penile shaft; frozen shoulder.
  2. Earlier age of onset; younger than 45 years, and sometimes teens
  3. Positive family history
  4. Multiple fingers involved
  5. Ethnicity to Scandinavia and the UK
  6. More often bilateral involvement
  7. Faster development once started
  8. More Dupuytren recurrence problems after surgical repair of the fingers or palm.

Of this group the first four are most clinically significant.

The importance of recognizing the presence of a Dupuytren’s diathesis is that it indicates a condition that is more tenacious for recurrence after surgical repair and more likely to worsen, as well, in spite of efforts for correction.

Therefore, from my experience, this indicates that those with a Dupuytren diathesis should be slower and more reluctant to submit to surgical intervention and faster to attempt non-invasive Alternative Medicine support to attempt natural elimination or reversal of the Dupuytren cords that result in finger contractures.

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