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Ian asked...

Is there any link with metastatic melanoma and dupuytrens? I am 41 and have never smoked or drank alcohol and have dupuytrens that seem to be growing quickly - from 1st nodule to cords growing in 1 month. There is a lot of pain too. My doctor just said there is nothing they will do until it gets to full contracture. Any tips on what to do next?

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The Answer

Dupuytrens is a condition that affects the hands and fingers, which causes the fingers to bend into the palm. It is thought to be more genetically linked but diabetes, smoking and some medications can also cause this condition. It is a condition that is non-cancerous, and non-life threatening. Current research does not indicate there is any link between Dupuytrens Contracture and Metastatic melanoma.

Treatments can be non surgical and surgical and doctors, as a rule, do not like treating unless it is affecting full functioning of the hand.

Initial non evasive treatment which may be of help can include massaging the affected area and exercise/physiotherapy to assist with blood flow to the area and help loosen the contracture.

Non surgical treatments include radiation therapy, which is done to the nodes and cords. The way this works is to interfere with the growth of the fibroblasts which cause the nodules.

Another non surgical treatment is collagenase injections that break down the cords.

Surgical treatments that one can have are open fasciotomy, where the shortened connective tissue is cut to relieve tension, and a fasciectomy, where the shortened connective tissue is removed. With surgery, this treatment would need to be hospital based. Surgery, however, does not stop the progression of the condition. I would suggest going back to your GP and looking at possible referrals to physiotherapy, as an initial start, and then looking at these other options, if your condition is affecting your daily life.

In relation to pain relief, I would also suggest discussing this with your GP, but anti-inflammatories can sometimes be helpful, if indicated and appropriate.

Good websites which would give you further information include: www.dupuytrens.co.uk

Answered by the Health at Hand nurses

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