A survey of clinical manifestations and risk factors in women with Dupuytren’s disease


Published online: Aug 30 2008

Ilse Degreef, Pieter Steeno, Luc De Smet

From Leuven University Hospitals, Pellenberg, Belgium

Abstract

Dupuytren’s disease is very common, with a prevalence of up to 40% in the Scandinavian population. Although many epidemiological surveys have been conducted, little is known about its aetiology. Multiple risk factors in Dupuytren’s disease have been identified. About 80% of the affected patients are male. Even though recent data suggest similar outcome after surgical treatment in the female patient, recurrence after surgery is more frequent. To assess Dupuytren’s disease in women, a record analysis and a survey of risk factors was conducted in 130 female patients surgically treated at our institution between 1988 and 2005. With a response rate of 52%, 65 women were included (6 patients were confirmed dead). The mean age of onset of the disease was 50 years and 6 months. After a mean follow-up of 7 years and 7 months (2y1m to 21y9m), recurrent disease after surgery was reported in 42%. Bilateral disease was present in 54%, unilateral in 26% right and 20% left hands. The fifth finger was involved in 77%, the 4th finger in 48% and the 1st ray in 14%. Ectopic lesions were seen in 19%, with a positive family history in 55%. Only one patient had a confirmed alcohol abuse ; 22% were smokers. There were 32% manual workers. Shoulder pain was present in 54% of the patients, with confirmed diagnosis of frozen shoulder syndrome in 45%. High cholesterol was diagnosed in 39% and only 6% had diabetes. Epilepsy was seen in 5%. High disease recurrence and factors related to an aggressive course of the disease are present in female patients with Dupuytren’s contracture, with a high family history occurrence, bilateral disease and associated Ledderhose disease. Several known risk factors were present : high cholesterol, smoking and manual work. Frozen shoulder showed a very high prevalence in women with Dupuytren’s disease.