Skin involvement in Dupuytren's disease.
Whether the palmar skin has a role in the development, propagation or recurrence of Dupuytren's disease remains unclear. Clinical assessment for skin involvement is difficult and its correlation with histology uncertain. We prospectively biopsied the palmar skin of consecutive patients undergoing single digit fasciectomy (for primary Dupuytren's disease without clinically involved skin) and dermofasciectomy (for clinically involved skin or recurrence) in order to investigate this relationship. We found dermal fibromatosis in 22 of 44 patients (50%) undergoing fasciectomy and 41 of 59 patients (70%) undergoing dermofasciectomy. Dermal fibromatosis appeared to be associated with greater preoperative angular deformity, presence of palmar nodules and occupations involving manual labour. Dermal fibromatosis exists in the absence of clinical features of skin involvement and we hypothesize that the skin may have a greater role in the development and propagation of Dupuytren's disease than previously thought.


METHODS
III.
Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK.
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R
Wade
Norfolk and Waveney Cellular Pathology Network, Cotman Centre, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK.
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L
Igali
Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK andrea.figus@nnuh.nhs.uk.
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Figus
D000368:Aged; D015331:Cohort Studies; D004387:Dupuytren Contracture / Q000150:complications / Q000473:pathology* / Q000601:surgery; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012867:Skin / Q000473:pathology*
Contracture; Dermal; Dermis; Dermofasciectomy; Disease; Dupuytren’s; Fasciectomy; Fibromatosis; Graft; Outcome; Recurrence; Risk; Skin