Pathology: Dupuytren’s contracture

Dupuytren’s contracture is commonly seen in the 4th or 5th digit of a cirrhotic’s hand, though it is not specific for cirrhosis.  Since it is often seen in alcoholics and diabetics, ALD and NASH may certainly be predisposing illnesses. 

It is not entirely clear why the palmar fascia becomes abormally thick with collagen (type III > type I) deposition.  However, this fibrogenic phenomenon is seen in other organs of the body in cirrhosis as well, including the myocardium (which is a finding in cirrhotic cardiomyopathy-diastolic type). 

Dupuytren’s contracture is, more or less, an interesting physical finding, and does not require intervention unless the patient is physically incapacitated by it.  In such cases, a selective fasciectomy is indicated.

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