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To understand Dupuytren’s, first understand women.

Is Dupuytren’s a tumor – an independent growth, or is it a reaction of normal tissues to a stimulus? Is a woman one person or several people sharing the same body? This paper answers both questions. Every female human has two X chromosomes, one from each parent, but in any individual cell, only one X chromosome is active, the other permanently inactivated. One X chromosome rules half of a woman’s cells, the other rules the other half, and these cells are evenly mixed throughout her body. Now, true neoplastic tumors are clones: one cell reproduces over and over, and so in females all cells of a tumor will have the same active X chromosome. In contrast, reactive tumors are many adjacent cells responding to a common stimulus, and will have a normal mix of active X chromosomes. This fact was used to show that Dupuytren’s nodules are not true tumors, not bad cells, but a reaction of normal cells to some stimulus. What is it?