Dupuytren's contracture is associated with: (1,2)
- manual labour
- uncertainty around the association between Dupuytren's disease and manual labour, in particular the use of vibrating tools
- many authors have linked repetitive hand trauma associated with certain occupations to the development of Dupuytren's disease
- hand trauma
- most experts would concede, however, that a one-off hand injury can rarely trigger Dupuytren's disease and that a history of manual labour indicates a worse prognosis
- epilepsy / treatment with phenobarbitone or phenytoin
- controversy exists as to the significance of either anticonvulsant drugs or epilepsy
- link between Dupuytren's disease and epilepsy remains unclear, although latest evidence suggests that the association may be due to the effect of certain antiepileptic medications
- Peyronie's disease
- smoking and excessive alcohol intake are independent risk factors for disease development
- in both cases the relation is dose dependent (odds ratio 1.5-2 for smoking and 1.35-4.2 for alcohol)
- chronic liver disease is not a risk factor independent of alcohol consumption
- a family history of Dupuytren's contracture
- there is a strong genetic association with study evidence showing up to an 80% heritability
- trauma
- myxoedema
- diabetes mellitus
- more prevalent among people with diabetes, especially those dependent on insulin
- diabetic patients tend to have a milder form of the disease
- hypercholesterolaemia
- patients with Dupuytren's disease have also been noted to have raised serum lipids compared with controls
- AIDS
It may also be idiopathic.
Development of Dupuytren's contracture may result from the disturbed metabolism of oxygen-derived free radicals causing fibroblast proliferation and palmar fibrosis.
Reference:
- Karbowiak M, Holme T, Khan K, et al. Dupuytren's disease. BMJ. 2021 Jun 4;373:n1308.
- Boe C, Blazar P, Iannuzzi N. Dupuytren contractures: an update of recent literature. J Hand Surg Am. 2021 Oct;46(10):896-906.