Clinical Example: Pediatric Dupuytren's
| These are two unrelated
cases of apparent congenital Dupuytren's
contracture. Both children had palmar nodules present at birth. These
photos were taken by their parents. This is a rare circumstance.
The existence of infantile Dupuytren's is controversial. It can not be
proven definitively even with tissue samples, and this clinical picture
may represent diagnoses other than Dupuytren's, such as eosinophilic fasciitis,
melorheostosis, focal scleroderma or other unknown diagnoses. Published opinion is divided as to whether this should be treated with
splinting alone, local fasciectomy or aggressive dermofasciectomy and skin graft. |
| Click on each image for a larger picture |
| Case 1. This three year old boy had
a palmar nodule at the base of the ring finger present at birth. At six
months of age, an excisional biopsy was performed, which was
interpreted as showing Dupuytren's disease. He has since developed
flexion contractures of the ring and small fingers. The referring hand
surgeon describes these as looking and feeling "just like Dupuytren's". |
| Case 2. This 9 year old boy had a
nodule in the palm noted at birth, as well as punctate dark pigmented
lesions and skin dimpling noted in the upper arms and thighs. He has
had no biopsy. Over the last three or four years, he has had a
progressive flexion contracture of the right ring finger as well as
palmar thickening and dimpling. |
| The dates on these photos
are inaccurate. |
| Axillary lesions. |
| Thigh dimple, one of
several. |
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