Dupuytren Foundation

What other conditions predispose to Dupuytren?

Genes Dupuytren’s disease is most common in white males of Northern European descent 1810624, 10050242. It is uncommon in blacks 11770364, 9665514, 8074370, and in blacks is more often associated with a history of trauma 8891992. A US Veterans study gave this racial breakdown: the incidence of Dupuytren’s in their study was Caucasian: 0.7%; Hispanic: 0.2%; Black: 0.1%; Native American: 0.1%; Asian: 0.07% 10883614. Dupuytren’s is six times more common in men than women 10883614, 10473157. Women develop the disease on the average ten years later than men 11357696, 10473157. The disease appears to run in families, and often follows an autosomal dominant inheritance 10050243. Dupuytren’s contracture has been reported in in 21% of women and 39% of men over the age of 60 in North-east Scotland. 8501390. Even with a genetic predisposition, presentation is variable, and identical twins with Dupuytrens do not necessarily have identical disease 8345271. There are genetic differences between patients with and without Dupuytren’s 12794452, 12783014 , 11924651. Although a genetic pattern of HLA DR antigens has been reported in both Dupuytren’s and scleroderma 6334711, a “Dupuytren’s gene” has not been identified 11895345.
Age Increasing age increases the risk of developing Dupuytren’s 3592873. Although reported in infants 11418917,3924790 children 12703034 , 11912542 and teenagers 8676015 , this is rare. Other childhood conditions11117052 may mimic Dupuytren’s, such as the benign recurring digital fibroma of childhood or malignant epithelioid sarcoma 11912542, 10612139, 7719607. In Iceland, where it is common, Dupuytren’s in men found in 7% in the age group 45-49 years, 40% in those 70-74 years old 10760640. In Norway, 30% of the population over 60 has Dupuytren’s 10050243.
Diabetes There is a five 7713273 to ten 9382632 times increased risk for diabetics to develop Dupuytren’s contracture8697659, 7722249, 10883614, 2522373, 10760640, related to the duration 3590817, 6343018, presence of diabetic retinopathy 6343018, but not severity of the diabetes 6608923, 6343018, 9002027, 2725939. In diabetics, Dupuytren’s is often a less aggressive form, but the radial hand is more often involved 6725338.
Diabetic Limited Joint Mobility Syndrome Patients with this are twice as likely to have Dupuytren’s than with diabetes alone 2057690, 2522373, 6608923,2968881, and relates to the duration of diabetes 4042798. The relationship may be explained by smoking, which predisposes to both conditions 2022177, 2522859
Smoking Smokers have increased risk 9119843, 10883614, 2022177, 25228593592873, 10760640, 10760640. Twice the risk of nonsmokers 3225413
Alcoholism Increased 2871816, 10883614, although some surveys dispute this 8426337, 11697563 The association may instead be with smoking 9119843 or hyperlipidemia associated with alcoholism 1447259, or alcoholic liver disease 7224858, 190684. Alcoholic liver disease is a risk factor,  nonalcoholic liver disease is not 3592873, although this is also disputed 6672504.
Thyroid disorders Increased incidence, more for hypothyroidism than hyperthyroidism 12864792
Stretching Contrary to natural instinct, the act of stretching the skin of the palm appears to aggravate or provoke Dupuytren’s contracture 6884845.
Frozen Shoulder 50% chance of developing Dupuytren’s 11307078, 10509873, even more common with diabetes 10509873
Peyronie’s Disease 15 – 25% incidence 7150935, 9636000, 8976282, 80% in familial forms of Peyronie’s 6980996.
Lederhosen Disease 28% chance of having Dupuytren’s 10919621
Rheumatoid Arthritis Lower chance of developing Dupuytren’s 10568426, 6747420, but when present, requires special surgical planning 3336640
Trauma Dupuytren’s may develop after hand trauma 3592873, 3744141, 4031627, particularly after Colles’ wrist fracture (distal radius fracture) 3998585, 9382639, 1588210. One study reported a 40% incidence of Dupuytrens 18 months after Colles’ fracture 10372776. Duputren’s developing after surgery has also been reported 8856538.
Hyperlipidemia Increased 1447259
Vibration exposure Increased with vibration exposure 8732927, Patients with vibration white finger syndrome two times as likely to have Dupuytren’s  1345125
Epilepsy When present, Dupuytrens appears to have a more aggressive character 1588209, although conflicting reports exist  932769. Association may be due to  phenobarbitone  medication rather than epilepsy itself 932769,10751924 , although this is debatable as well 1588209. There may be an association between Dupuytren’s, RSD and antiepileptic drugs 8156963, 2691374.
Gout No effect 1588208.
Glucosamine / Chondroitin Sulfate Glucosamine / Chondroitin sulfate preparations are available as nutritional suppliments with claims of improving joint function. Although no cause and effect relationship has been established, chondroitin sulfate 9517845,2493650, 6489852 and glycosaminoglycan 6854215 levels are elevated in the tissues affected by Dupuytren’s contracture.
Growth hormone therapy Possibly 8101283
Arcus senilis Increased incidence, possibly due to mutual association with hyperlipidemia 1280972
Reflex Sympathetic Dystrophy RSD after wrist fracture triples the risk of developing Dupuytren’s compared to no RSD 10372776. There may be an association between Dupuytren’s, RSD and antiepileptic drugs 8156963 . More common postop in women2229974 and possibly related to psychological factors 1692417. There may be an association between Dupuytren’s, thoracic outlet fibrosis and reflex sympathetic dystrophy 2707653
 Hemodialysis Increased, although many factors may be at play 3113084
Palmaris longus Increased risk if this tendon is present in the wrist 3794480. Excision of the palmaris longus tendon has been reported to reduce recurrence 3740784
Increased serum IgA Increased risk 6672504, 6353806
Vascular insufficiency  Increased risk 8501389
Manual Labor Increased risk 10760640, 9382639, although controversial 10050242, 8732927, 1834729. Vibration exposure is a risk factor 8732927, 8672800, 1345125
Carpal tunnel syndrome Although postoperative flare has been reported as more common with simultaneous fasciectomy and carpal tunnel release 7430596, contrary reports exist 2061659.
Vinyl Chloride HLA DR antigens have been identified both in Dupuytren’s patients and in patients with vinyl chloride exposure related scleroderma 6334711. An increased incidence of  Dupuytren’s was reported at a polyvinyl chloride (PVC) manufacturing plant in workers who extensively handled the product 7066227.
HIV infection Increased risk debated 10050242