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Dupuytrens Contracture 20-Nov-2004 At 12:22:46 PM Julian

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Hi there. sorry this reply took so long, but it would have been quicker if there were fewer injured climbers over the last couple of weeks!

PALMAR and PENILE FIBROMATOSIS

Not much more to add to chris’s post (thanks for popping that in in my absence fella. I note you have been studying diligently!) It is a genetic trait (autosomal dominant, for those interested) and is most common in Northern Europeans and those bloody good looking Scandinavians (ie Anglo-Saxon descent). In fact, a large part of the Viking history can be tracked using this disease as a marker. The ring finger is affected most often, followed by the little, middle, and index fingers. There is a high incidence in epileptics receiving phentoin therapy and patients with AIDS. There are less strong associations with liver disease, in particularly alcoholic cirrhosis, diabetes, thyroid problems, and pulmonary tuberculosis. It has been theorised that it arises from a complex biochemical reaction involving oxygen free radicals. So don’t drink and don’t smoke.

Not surprisingly, males are affected more frequently than females in Peyronie's disease. There is a similar predominance for Dupuytren's, occuring mostly in males over 35 years of age. In 20-25% of cases palmar fibromatoses (Dupuytren's) stabilise, with no further progression. A small percentage actually spontaneouly resolve.

Treatment is as Chris has suggested, though recurrence is as high as 50% after 10 years. Current research is looking at enzyme injections to selectively break down the nodular tissue.

julian