With Dupuytren's, scar tissue develops underneath the skin of the palm. As the disease progresses, the scar tissue shrinks. This slowly pulls the fingers into in a bent position called a contracture. Over time, Dupuytren’s curtails daily activities.
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"The ring and the small finger are more affected than the other fingers," says Charles Eaton, MD, a hand surgeon who has treated many patients with Dupuytren's and is founder of the Dupuytren Foundation in Jupiter, Fla. People can often get by in early stages. That's because slight bending works fine for many daily activities, he says. In fact, many people at these early stages may not even know there's a problem, or they might confuse it with something else.
Early Stages of Dupuytren's
In most cases, Dupuytren's first appears after the age of 40. The first sign at this stage is a lump in the palm of the hand.
"Many people mistake it for a callus," says Eaton. "They think they've done something with their tennis or golf grip. Or they just believe they have a callus and don't think anything of it because it doesn't bother them at all."
Symptoms During Early Stages
In addition to a lump, some Dupuytren's patients will have burning, itching, or temporary tenderness in the area as well. "Patients describe the tenderness as similar to a bruise that is resolving or a cut that is in the last stages of healing. It can also be mistaken for tendonitis but it affects a layer of tissue directly under the skin and tendons are not directly involved."
At this stage, the hard lumps in the palm are called nodules. They may go away on their own in a small number of patients, but they usually progress. They can stay for months or years before anything else happens, says Eaton.
Although many types of treatment have been tried for early stages, few have shown a benefit. "A long-lasting cortisone injection into the nodules [may] have the ability to turn the disease process off, at least temporarily," Eaton says. This may delay Dupuytren's contracture progression. In some cases, a series of injections is needed for best results.