Dupuytren Disease Infiltrating a Full-Thickness Skin Graft

J Hand Surg Am. 2016 Aug;41(8):e235-8. doi: 10.1016/j.jhsa.2016.04.011. Epub 2016 Jun 7.

Abstract

Although the role of the skin in the development and propagation of Dupuytren disease remains unclear, dermofasciectomy and full-thickness skin grafting (FTSG) appears to delay recurrence. In 2011, a 71-year-old, left-handed man presented with recurrent Dupuytren disease in the dominant hand. In 1991, he originally underwent a primary dermofasciectomy and FTSG for Dupuytren disease involving the palmar skin. Twenty years later, the left middle finger was drawn into flexion by a recurrent cord, and the old graft and adjacent palmar skin were clinically involved by fibromatosis. We performed a revision dermofasciectomy and FTSG. Microscopic analysis of the excised graft demonstrated dense infiltration of the entire skin graft by Dupuytren disease, with areas of active and burnt-out fibromatosis distinct from hypertrophic scarring. This report of Dupuytren fibromatosis infiltrating a skin graft raises questions about the pathophysiology of Dupuytren disease.

Keywords: Dupuytren; dermofasciectomy; fibromatosis; recurrence; skin.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy, Needle
  • Dupuytren Contracture / diagnosis
  • Dupuytren Contracture / pathology*
  • Dupuytren Contracture / surgery*
  • Fasciotomy / adverse effects*
  • Fasciotomy / methods
  • Follow-Up Studies
  • Hand Strength
  • Humans
  • Immunohistochemistry
  • Male
  • Physical Examination
  • Range of Motion, Articular / physiology*
  • Recovery of Function / physiology
  • Recurrence
  • Reoperation / methods
  • Risk Assessment
  • Severity of Illness Index
  • Skin Transplantation / methods*
  • Time Factors
  • Treatment Outcome