The Proliferative Phase of Dupuytren's Contracture
Dupuytren’s Contracture is the appearance of nodules or curling of the fingers inward towards the palm. This occurs due to changes that take place under the skin of the palm. The mere appearance of a small bump in the palm gradually grows into what is called a contracture.
Difference Between a Contracture and Dupuytren’s Contracture
The main difference between a normal contracture and Dupuytren’s Contracture comes down to where this deformity develops in the body. In medical terms, a contracture is the tightening of muscles or tendons in any part of the body. Dupuytren’s contracture, on the other hand, causes the tightening of muscles in the hand, specifically, the palm.
Some people believe that Dupuytren’s Contracture first develops in the fingers, but this is incorrect. The palm is the first area affected in any individual. When left untreated, the disease progresses and starts to affect the fingers as well.
Progression of Dupuytren’s Contracture
Similar to some other diseases, Dupuytren's progresses with time. Its rate of progression is slow, which is a good sign compared to some other conditions. However, the symptoms can still cause problems if they are not stopped in time. Research has revealed the following three phases of Dupuytren's contracture:
- Proliferative Phase
- Involutional Phase
- Residual Phase
Proliferative Phase of Dupuytren’s Contracture
This is the first phase and the earliest sign that someone has Dupuytren’s Contracture. In this phase, structures called myofibroblasts are proliferated, or created in excess. Myofibroblasts are cells located in the palm between smooth muscle cells and standard muscle tissue cells, called fibroblasts. This rapid multiplication of such cells leads to the development of a nodule in the palm.
In this stage, patients usually report a tender or even a slightly painful feeling where the nodule develops. This pain is due to nerves becoming compressed or pushed down as a result of excess myofibroblasts being produced.
When doctors do a physical examination of someone's hands during this phase, they are using their eyes to look for certain symptoms or features. The hands of someone in the proliferative phase of Dupuytren's contracture are what is called blanch blush.
Blanch blush describes the change in color of the skin on the palm when it is fully extended. When the hand is overextended, the skin in between the finger joints will often become red due to pooling of blood and an increase in circulation. This causes the palm to become pale (or blanched) since blood is traveling away from this area and causing impaired circulation. This stage of Dupuytren's isn’t typically painful, but some patients do report slight discomfort. When doctors see patients who are in the proliferative phase of Dupuytren's contracture, it is typically quite evident once they observe the appearance of blanch blush on one or both hands.
The proliferative stage of Dupuytren’s Contracture should not be ignored, as it is early enough and quite possible to stop the progression of the disease at this stage. The best way to reduce its spread is to use a reliable Dupuytren's contracture cream that helps prevent tightening of the skin and immobility of the hand.