title: Dupuytren's contracture as result of prolonged administration of phenobarbital.
abstract: Dupuytren's disease is a fibroproliferative condition involving the superficial palmar fascia, leading to a progressive and irreversible flexion of the fingers. In literature, there are different opinions regarding the phenobarbital, a common antiepileptic drug, and its effective role in the genesis and development of Dupuytren's disease. In this retrospective investigation the association between phenobarbital and Dupuytren's contracture is discussed. Three patients in treatment with phenobarbital who had no others significant risk factors for Dupuytren's contracture were included in this study. The disease occurred after one to four years of drug therapy, at dosage of 100 mg/day. After surgery, Dupuytren's disease showed different evolutions in relation to dosage and type of antiepileptic drug used. Phenobarbital causes a dose and time-dipendent profibrotic effect. A clinical regression was observed when phenobarbital was substituted by carbamazepine, maintaining the same dosage (100 mg/day). This data confirms that not all the antiepileptic drugs are implicated in palmar fibrosis, and suggests that, according to the efficacy and adverse effects, the administration of benzodiazepine reduces the risk of Dupuytren's recurrence.
authors.affiliation: Reconstructive and Plastic Surgery, Dipartimento di Discipline Chirurgiche ed Oncologiche, Palermo University, Italy. matripoli@yahoo.it
authors.forename: M
authors.initials: M
authors.lastname: Tripoli
authors.forename: A
authors.initials: A
authors.lastname: Cordova
authors.forename: F
authors.initials: F
authors.lastname: Moschella
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects*; D002220:Carbamazepine / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D057915:Drug Substitution; D004387:Dupuytren Contracture / Q000139:chemically induced* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D010634:Phenobarbital / Q000008:administration & dosage / Q000009:adverse effects*; D026741:Physical Therapy Modalities; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D010634:Phenobarbital