How Dupuytren’s Contracture Progresses
When Dupuytren's Progresses: Symptoms During Later Stages
Dupuytren’s tends to progress more rapidly in men than in women and in those who have both hands involved. As Dupuytren's progresses, the nodules thicken into cords that feel like strings beneath the skin. The skin begins to shrink in the area that once felt lumpy. What happens is similar to what happens when the body heals open wounds, says Eaton. The wound triggers a scarring and shrinking process, and the body gradually pulls the edges of the skin together so that the wound is closed.
With Dupuytren's contracture, this process is activated inappropriately, says Eaton. "If you biopsy tissue that’s active with Dupuytren's, you'll find that the biology is very much like what you'll see with an open cut."
When do symptoms become a problem? People begin to notice changes, says Eaton, if the shrinkage causes contraction that is enough to limit the motion of a finger. Most people notice tightness in their fingers when they can't straighten them all the way. As the condition progresses, it can interfere with the use of the hand.
How Life Is Affected by Dupuytren's Contracture Progression
The greater the degree of contracture, the greater Dupuytren’s will affect your daily activities. Those who do activities where the palm needs to be stretched flat may notice the tightness of Dupuytren's progression earlier than others, says Eaton. Musicians who play keyboard or reed instruments need to spread their fingers, so they may notice the changes early on.
"Just imagine your ring finger bending and not being able to straighten," says Eaton. After a point, you will have trouble doing very specific activities, such as getting your hand into your pocket if you're wearing tight jeans or reaching into a narrow space to put a seat belt into the slot.
As the finger bends farther and gets closer to 70-80 degrees, applying shaving cream or scrubbing the scalp with shampoo also becomes tough because flattening the palm isn't possible.
As the bend gets closer to 90 degrees or more, you may have trouble putting on gloves or washing your face.
With fingers pointing down at 135 degrees or more of bend, hygiene can become a problem because the folds of skin become difficult to dry. As a result, they may develop foul-smelling fungal infections similar to athlete's foot.