Rayan G M
Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Hand Clin. 1999 Feb;15(1):87-96, vii.
The clinical presentation of Dupuytren's disease is discussed with emphasis on dermato-pathology, the nodule, the cord, ectopic manifestations regional and distant, and disease progression. The differential diagnosis also is described with a list of pseudo-Dupuytren's disease cases. Observations by this author suggest that there are two distinct clinical entities responsible for palmar fascial contracture, namely typical Dupuytren's disease and atypical Dupuytren's contracture. These two types seem to differ in presentation, treatment, and prognosis. The characteristic clinical findings of each of these two types are described. The disparity among treatment outcome studies and epidemiologic studies with regard to the prevalence of Dupuytren's disease is probably in part due to lack of distinction between these two clinical types. Accurate diagnosis and satisfactory treatment outcome can be achieved by careful history, thorough physical examination, and keen understanding of the pathophysiology of this enigmatic disease.
本文讨论了杜普伊特伦挛缩病的临床表现，重点介绍了皮肤病理学、结节、条索、局部和远处的异位表现以及疾病进展。还描述了鉴别诊断，并列举了假性杜普伊特伦挛缩病病例。作者的观察表明，有两种不同的临床实体可导致掌腱膜挛缩，即典型的杜普伊特伦挛缩病和非典型的杜普伊特伦挛缩。这两种类型在表现、治疗和预后方面似乎有所不同。文中描述了这两种类型各自的特征性临床发现。治疗结果研究和流行病学研究在杜普伊特伦挛缩病患病率方面存在差异，这可能部分是由于未能区分这两种临床类型。通过仔细询问病史、全面的体格检查以及对这种疑难疾病病理生理学的深入理解，可以实现准确诊断和满意的治疗效果。
