Dupuytren's disease: is surgery still the best option?

Dupuytren's disease can have a significant impact on the daily lives of patients. Traditionally, treatment focused on surgical correction, but advances in rheumatic pharmacology and surgical techniques have opened up a wider scope of management options. Here the authors give a background of the disease and its treatment, while providing evidence for a link with Peyronie's disease.
Source: Trends in Urology and Men's Health - Category: Urology & Nephrology Authors: Tags: New approaches Source Type: research

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What Are the Causes of Dupuytren's Contracture?
Source: eMedicineHealth.com - Category: General Medicine Source Type: news
Conclusions: The collagenase clostridium histolyticum and percutaneous needle fasciotomy groups had similar outcomes for Dupuytren’s contracture with 3 years’ follow-up. Recurrences were frequent among patients with stage II proximal interphalangeal joint contractures. The Unité Rhumatologique des Affections de la Main scale and Quick Disabilities of the Arm, Shoulder and Hand questionnaire score decreased significantly for both groups at final follow-up. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
Source: Plastic and Reconstructive Surgery - Category: Cosmetic Surgery Tags: Hand/Peripheral Nerve: Original Articles Source Type: research
In the serious forms of Dupuytren disease, passive extension during surgery often results in unmasking a loss of skin substance that makes primary closure impossible. Our objective in this study was to describe and assess the therapeutic possibilities of a 3 local flaps surgical approach in serious forms of Dupuytren disease, using the lateral skin expansion because of the cord. A cadaveric study was carried out on 12 adult nonembalmed, fresh frozen hands. For each specimen, a loss of skin substance was simulated on the palmar side of the fifth finger at the level of the proximal digital flexion crease. Coverage involved a...
Source: Techniques in Hand and Upper Extremity Surgery - Category: Surgery Tags: Techniques Source Type: research
Conclusion: This study indicates that collagenase vs. fasciectomy treatment may be related to a lower rate of workplace absence and lower indirect cost in a year following the treatment. PMID: 32408788 [PubMed - as supplied by publisher]
Source: Expert Review of Pharmacoeconomics and Outcomes Research - Category: Health Management Tags: Expert Rev Pharmacoecon Outcomes Res Source Type: research
Dupuytren's disease can have a significant impact on the daily lives of patients. Traditionally, treatment focused on surgical correction, but advances in rheumatic pharmacology and surgical techniques have opened up a wider scope of management options. Here the authors give a background of the disease and its treatment, while providing evidence for a link with Peyronie's disease.
Source: Trends in Urology and Men's Health - Category: Urology & Nephrology Authors: Tags: New approaches Source Type: research
Publication date: November 2019Source: The Journal of Foot and Ankle Surgery, Volume 58, Issue 6Author(s): Jeffrey D. Lehrman, Amy L.L. Miceli, Simon G. Tabchi, Mark A. KaplanAbstractPlantar fibromatosis, also known as Ledderhose's disease, is a rare disorder of benign fibroblast proliferation involving the plantar aponeurosis (i.e., plantar fascia). Traditionally, surgical intervention has been the most common treatment for plantar fibromatosis. However, numerous studies have reported high recurrence rates of plantar fibromatosis after surgical intervention, as well as wound healing difficulties and nerve injury. Plantar ...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
Verteporfin is registered in the USA and Europe for the treatment of macular degeneration. It is a synthetic benzoporphyrin derivative, which acts as a photosensitizing agent and can be activated by low-intensity laser light. Recent studies with fibroblasts derived from nodules of patients with Dupuytren disease showed that verteporfin in inactivated form significantly decreased the expression of specific fibrotic genes (ACTA2, CCN2, COL1A1, COL5A1, EDA-FN, LOXL2, PLOD2 and SerpinH1), probably by blocking the transcriptional activation of targets in the Yes-Activated Protein (YAP) cascade.
Source: The Journal of Urology - Category: Urology & Nephrology Authors: Tags: Sexual Function/Dysfunction: Peyronie's Disease I Source Type: research
In the absence of effective non-surgical treatments for PD, CCH is an alternative in patients who are not willing a surgery. The use of CCH as a non-invasive treatment of PD has a level of evidence 1B according to the 2017 EAU Male Sexual Dysfunction guidelines. Percutaneous Needle Fasciotomy is a minimally invasive technique used in the treatment of Dupuytren disease with good results and few complications. Leriche technique, described for PD, consists of creating holes inside the plaque percutaneously.
Source: The Journal of Urology - Category: Urology & Nephrology Authors: Tags: Sexual Function/Dysfunction: Peyronie's Disease I Source Type: research
Peyronie ’s disease (PD) is inherited in a subset of men and has a co-prevalence of ∼20% in men with Dupuytren’s disease (DD), a related fibrotic diathesis. Recent forward-genetic screening for genetic factors with potential involvement in PD and DD identified several candidate genes involved in fibros is and inflammation. Here, we examine nucleotide-level genetic alterations with potential involvement in pathogenesis of PD and DD in a father-son duo using whole-exome sequencing.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Oral session Source Type: research
Peyronie ’s disease (PD) results in abnormal inflammation and fibrotic plaque development in the penile tunica albuginea (TA), and can limit sexual intercourse. The genetic factors predisposing to PD are unknown. We sought to identify genes involved in PD, and herein present data implicating NELL1, a secre ted growth factor involved in fibrosis and inflammation, and CTDSPL, a phosphatase involved in the TGF-β pathway and inflammation, in Peyronie’s and Dupuytren’s diseases (DD).
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Poster session Source Type: research
More News: Drugs & Pharmacology | Dupuytren's Contracture | Peyronie's Disease | Rheumatology | Urology & Nephrology