| Scientific understanding and clinical management of Dupuytren disease. | |
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MedLine Citation:
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PMID: 21060335 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Dupuytren disease (DD) is a fibroproliferative disorder of unknown etiology that often results in shortening and thickening of the palmar fascia, leading to permanent and irreversible flexion contracture of the digits. This Review provides a detailed update of the scientific understanding of DD and its clinical management, with perspectives on emerging research and therapy. Established risk factors include genetic predisposition and ethnicity, as well as sex and age. Several environmental risk factors (some considered controversial) include smoking, alcohol intake, trauma, diabetes, epilepsy and use of anticonvulsant drugs, and exposure to vibration. DD has been variously attributed to the presence of oxygen free radicals, trauma to the palmar fascia, or aberrant immune responses with altered antigen presentation, or to interactions between these proposed mechanisms. The presence of immune cells and related phenomena in DD-affected tissue suggests that DD is possibly immune-related. Mechanically, digital contracture is caused by myofibroblasts in the DD palmar fascia; however, the exact origin of this cell type remains unknown. The mainstay of treatment is surgical release or excision of the affected palmodigital tissue, but symptoms often recur. Nonsurgical correction of DD contractures can be achieved by Clostridium histolyticum collagenase injection, although the long-term safety and recurrence rate of this procedure requires further assessment. |
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Authors:
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Barbara Shih; Ardeshir Bayat |
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Publication Detail:
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Type: Journal Article Date: 2010-11-09 |
Journal Detail:
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Title: Nature reviews. Rheumatology Volume: 6 ISSN: 1759-4804 ISO Abbreviation: Nat Rev Rheumatol Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-01 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101500080 Medline TA: Nat Rev Rheumatol Country: United States |
Other Details:
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Languages: eng Pagination: 715-26 Citation Subset: IM |
Affiliation:
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Plastic & Reconstructive Surgery Research, School of Translational Medicine, Manchester Academic Health Science Centre, Manchester Interdisciplinary Biocentre, University of Manchester, 131 Princess Street, Manchester M1 7ND, UK. |
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