Microvascular changes in Dupuytren's contracture.

Previous studies of certain fibrotic lesions (hypertrophic scar, keloid, pseudotendon) have revealed pervasive microvascular occlusion. Lowered oxygen tension is considered to be a stimulus to excessive collagen production and, hence, the scar. Because its characteristics are similar to those of other lesions, Dupuytren's contracture appeared to be a good model in which to confirm the presence of occluded microvessels. Six cases were examined by light, electron, and polarizing microscopy. Most of the microvessels from the precontracture band area throughout the periphery of the body of the nodules were occluded by a bulging of the endothelial cells into the lumen. The microvessels were surrounded by extensive layers of basal laminae. The nodules were essentially avascular. The presence of another fibrotic lesion in which pervasive microvascular occlusion occurs is suggestive of an underlying biologic principle concerning the generation of all fibrotic lesions.