Dupuytren’s is a fibrotic disease, a fibrosis – one of many. Fibrosis, as a word, sounds exotic, but it is really just the medical name for scar. Although injuries come in many forms and can involve any structure, our bodies have a limited repertoire for reacting to injuries. The universal poultice our body’s healing process puts into areas of injury is collagen. A scar is mostly collagen. When a broken bone heals, the body first glues the break together with collagen; calcium crystals form in this glue, eventually turning it into bone. Collagen is stuff we are made of: anything solid or mechanically important in our bodies, even bone, is mostly made of collagen. Collagen needed for us to live; collagen is good, but in the right place and in the right amount. Fibroses show that even for collagen, there can be too much of a good thing. If collagen is like the bricks making up the house in which our cells live, fibrosis is like adding extra bricks inside the house: too many bricks and the house stops being livable. Fibrosis may affect a specific location, as in Dupuytren’s, or may diffusely involve an entire organ, as in pulmonary fibrosis. Why do fibroses occur? This is the question we need to investigate on the quest to find a cure for Dupuytren’s. Drugs play a part in certain fibroses. In “Drug-Induced Localized Systemic Scleroses” (full text: https://dupuytrens.org/DupPDFs/1981_Graham_1601.pdf), the role of drugs and fibroses, including Dupuytren’s, is explored.
