Knots and Nodules in the Palm

Dupuytren’s disease is a condition that causes the tissue underneath the skin on your palm and fingers to tighten and thicken, producing knots and nodules at the base of your fingers. Over time, the knots can form cords that pull your fingers into a permanently bent position. The condition is usually painless and most often affects your ring and small fingers. It is sometimes referred to as Dupuytren’s contracture.

The cause of Dupuytren’s disease is unknown. The condition tends to run in families and is experienced more frequently by men than women.

Symptoms, Diagnosis and Outlook

Symptoms

The early symptoms of Dupuytren’s disease are often mild and slow to progress. Initial signs include a nodule or thickened skin on the palm of your hand. As the condition progresses, the skin on your palm appears dimpled or pitted. A firm lump may develop. Although it may be sensitive to touch, it should not be painful.

Over time, cords of tissue may develop and extend from the lump or nodule to either your ring or small finger. In later stages of Dupuytren’s disease, the cords may tighten and draw your fingers into your palm.

Diagnosis

In most cases, Dupuytren’s disease is diagnosed with an examination of your hands, which includes:

  • Comparison of both hands to check for puckering, lumps or tenderness
  • Assessment of your hand’s flexibility, strength, range of motion and feeling
  • Tabletop test to assess your ability to flatten your hand
  • Measurement and mapping of nodules and cords

Outlook

Dupuytren’s disease progresses at an unpredictable rate. More severe cases may require surgery to restore your hand’s function and mobility.

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