Fróðskaparrit - 01.01.1965, Page 103

Dupuytrens Contracture
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íingers of the ulnar side. The ring fingers are more often
affected followed by the little, middle, and forefingers.
It is a disease whose manifestations become most apparent
during the middle and latter period of life, although it has
been described at almost any age. There appears to be a predo-
minancy in men of about 7 to 1.
Pathology.
In Dupuytrens contracture part of the palmar fascia be-
comes thickened by fibrosis and undergoes contraction. The
short fibres from the fascia to the skin proliferate and contract
and obliterate all the subcutaneous fat, the sweat glands and
the blood and lymph vessels so that a continuous layer is
formed between the epidemis and the palmar fascia.
Histologically in the slower and more chronic condition,
the skin shows great thickening of the cornified layer, flatten-
ing of the stratum mucosum and obliteration of the papillae
of the corium. At a deeper ievel there is a dense layer of
cicatricial tissue. This tissue is more cellular and vascular in
the early stages but becomes thick, dense and fibrous.
The fibrous masses are poorly demarketed and fade out into
the surrounding fascia. These masses are composed of small
spindle shaped cells with elongated nuclei.
The cytoplasm is scanty and poorly outlined. The cells are
embedded in a matrix of fibrous tissue whose weavy pattern
is suggestive of normal fascia. Mitoses are not seen and the
cells are all alike. These fibrous masses are identical with the
benign fascial fibromas seen elsewhere.
In the more rapidly extending and cellular types it may be
difficult to differentiate the tissues from that of fibrosarcoma
on purely histological grounds.
Aetiology.
Innumerable theories have been advanced since the condition
was first described. It has been thought to be congenital and
familiar, neoplastic, inflamatory, traumatic, as result of con-