Dupuytren's disease - GenesisCare

Fascial fibromatosis

Dupuytren’s contracture is a common condition that causes thickening and tightening of the fibrous tissue beneath the skin on the palm of the hand, resulting in pain in the hand and fingers. It is also known as Viking disease, Celtic hand, or palmar fibromatosis, and is best described as having a claw hand or curled up fingers. Over time, the usually soft tissue becomes thickened and contracted, producing tight cords or nodules under the skin. These progressively cause the ring finger, and often fifth finger, to bend permanently. In the early stages, the disease can be quite subtle, but it is commonly found to be more extensive than initially suspected when assessed.

However, there have been recent reports suggesting that radiotherapy might well be able to assist and improve this condition. GenesisCare doctors have recently produced a case series and literature review which suggests functional recovery in 20-30% and stabilised disease in 40-80% with progression of the process in less that 10% of cases.

How long does the treatment take?

Low dose radiation therapy has a long history of use in patients with Dupuytren’s contracture. It is most effective when delivered relatively early during the disease’s progression at the nodule or cord phase, rather than in the fibrotic phase.

Treatment takes a week of superficial radiotherapy (using electrons, chosen for their limited penetration), a gap of six weeks and then second week of treatment.

A planning appointment is needed a few days before starting, and each day in the department will be less than an hour.

The toxicity from treatment is limited, there may be a slight colour change to the skin in the treated area which can be managed with a moisturising cream. Treatment is unlikely to cause significant discomfort.

Treatments we cover

Radiation therapy, also called radiotherapy, is used in the early stages of Dupuytren’s disease. Early treatment of Dupuytren’s using radiotherapy has been shown to slow or stop it worsening and prevent the fingers contracting. As a result the need for hand surgery can be avoided.

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References

Radiotherapy in fascial fibromatosis: C case series, literature review and considerations for treatment of early stage disease. Grenfell S, Borg M, JMIRO 58 (2014): 641-647

Author: A/Prof Michael Izard ADM The Master and Macquarie University Hospital