I was diagonosed about a year ago with one nodule in my right hand. I am 64 yo, female. Two sisters also have DC. both my hands are full of cords and my right hand is getting stiff and tender. I have been knitting alot this past year. Could that cause the DC to be aggresive? I have no contracture right now but the base of one finger is getting very firm and tender if I press on it. Thanks for any help!

I actually don't think that anything you do - or don't do - with your hands affects the progression of Dupuytren's. There is some evidence that serious trauma may bring it on, but even that is doubtful in my opinion. It's really a common condition with an unpredictable course. Go ahead and knit and don't worry about it.

Wolfgan, I believe there could be a link with occupations that actually damage tissue, for example operating a pneumatic hammer or playing the conga drums. Surgery or injury may trigger DC by initiating scarrring. But I doubt that any normal activities affect the progress of DC.

I also have Lederhose, and when I noticed a lump in one arch about 10 years ago, I was worried because it can become disabling. I read many posts advising seriously limiting running, walking and other activities on the theory that impact accellerates the progression. I decided to ignore those warnings and continued running and walking - quite a bit, actually. There has been little change in that lump in 10 years and it causes me no trouble.

So, I remain unconvinced that any normal activities have an effect on DC. I have serious, early-onset DC in both hands, and my hands have never received any serious trauma.

Hi Jim, I am far from being sure about what damage has what effect. Here are some thoughts (just ideas):

- the onset of Dupuytren's is certainly earlier than the first visible nodules. But nodules are the first thing what concerns patients, so typically doctors see patients not in earlier stages and the very first phase where Dupuytren's starts is thus difficult to research and hardly researched. I know only of one paper where the skin outside and away from nodules was analyzed and it turned out that the seemingly healthy skin was also exhibiting myofibroblasts, quite different from skin of healthy people. That seems to indicate that the disease starts in a much larger area than the nodule (which might explain the low recurrence rate of dermofaciectomy). The nodule is actually a follow-up stage where a tumor starts to grow in the diseased skin. This initial disease might (!) be fostered by damage of the tissue below the skin although the damage has no macroscopic, visible effect. But that's just speculation.

- some authors speculate that the fact that men get Dupuytren's on an avarage 10 - 20 years earlier than women is due to occupation, not due to biological gender difference. Actually that seems to be the current understanding, though that's no proof really.

- skin damage due to occupation might explain why Dupuytren's is more frequent than Ledderhose. To me that would sound resonable.

- I think we all agree that one can get Dupuytren's without damage. But maybe that means without visible damage and what we really inherit is a too sensible sub-skin tissue where micro-arteria often break and need to get repaired. That process eventually over-shoots, maybe driven by additional oxidative stress (also inherited, so it might require a combination). In this process an increasing amount of myofibroblasts exists in the sub-cutaneous tissue and eventually congregates into a nodule.

What does that mean in daily life? Treat your hands well, avoid damage, avoid very heavy use, avoid medium&frequent stress but keep using your hands and feet. Not using them would be silly and unhealthy. My guess would be that knitting is OK but I don't know much about knitting ...

Wolfgang

Quote:

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... I also have Lederhose, and when I noticed a lump in one arch about 10 years ago, I was worried because it can become disabling. I read many posts advising seriously limiting running, walking and other activities on the theory that impact accellerates the progression. I decided to ignore those warnings and continued running and walking - quite a bit, actually. There has been little change in that lump in 10 years and it causes me no trouble.

So, I remain unconvinced that any normal activities have an effect on DC. I have serious, early-onset DC in both hands, and my hands have never received any serious trauma.

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Edited at 03/25/08 19:17

I do know knitting. It is repetative but gentle. I continue with all my needlework.

Colleen