Dupuytren Disease Infiltrating a Full-Thickness Skin Graft.
Although the role of the skin in the development and propagation of Dupuytren disease remains unclear, dermofasciectomy and full-thickness skin grafting (FTSG) appears to delay recurrence. In 2011, a 71-year-old, left-handed man presented with recurrent Dupuytren disease in the dominant hand. In 1991, he originally underwent a primary dermofasciectomy and FTSG for Dupuytren disease involving the palmar skin. Twenty years later, the left middle finger was drawn into flexion by a recurrent cord, and the old graft and adjacent palmar skin were clinically involved by fibromatosis. We performed a revision dermofasciectomy and FTSG. Microscopic analysis of the excised graft demonstrated dense infiltration of the entire skin graft by Dupuytren disease, with areas of active and burnt-out fibromatosis distinct from hypertrophic scarring. This report of Dupuytren fibromatosis infiltrating a skin graft raises questions about the pathophysiology of Dupuytren disease.
Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom; Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom.
Ryckie George
RG
Wade
Department of Histopathology and Immunohistochemistry, The Cotman Centre, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, United Kingdom.
Laszlo
L
Igali
Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, United Kingdom; Department of Medical Education, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, United Kingdom. Electronic address: andrea.figus@nnuh.nhs.uk.
Andrea
A
Figus
D000368:Aged; D001707:Biopsy, Needle; D004387:Dupuytren Contracture / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D000071938:Fasciotomy / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D010808:Physical Examination; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology; D012008:Recurrence; D012086:Reoperation / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D016038:Skin Transplantation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
Dupuytren; dermofasciectomy; fibromatosis; recurrence; skin