When living with lupus, you may be all too familiar with achy and painful joint symptoms that can stop you in your tracks. Some MyLupusTeam members have shared that they also have a painful condition known as Dupuytren’s contracture, which causes one or more of your fingers to bend in toward your palm. It’s a genetic disorder that causes the connective tissue in your hands to thicken and tighten.

“Has anyone else found that they suffer from a condition called Dupuytren’s contracture? It hasn’t happened in a while, but I’d just like to know if anyone else has experienced it?” asked one member.

Keep reading to learn more about Dupuytren’s contracture, how it develops, and if it’s related to lupus. We’ll also cover common treatments you may receive when living with this condition.

What Is Dupuytren’s Contracture?

Dupuytren’s contracture — also known as Dupuytren’s disease — is a condition that affects the bands of thick tissue that run along your palm and fingers, the palmar fascia. It can affect any of your fingers, but the ring finger and pinky (fourth and fifth fingers) are the most common.

The first sign of Dupuytren’s contracture is when nodules or small bumps of tissue appear under the skin on your palm. They’re more common where your fingers connect to your palm. At first, the nodules may be tender, but they usually get better over time.

You’ll be able to feel the bumps under your skin, and — in some cases — you may even be able to see them. It’s important to note these bumps are noncancerous and only affect your hands. Some people only develop nodules, and their symptoms don’t get any worse.

In others, the nodules form into thick cords that shorten or contract. As the tissue shortens, it pulls your fingers in toward your palm. You may also notice deep dents or pits on your palms from the cords pulling your skin.

Eventually, the cords become so tight that they block your hand, and you struggle or find it impossible to completely straighten your fingers. You may also have a hard time holding on to or grasping objects. This condition is known as a contracture, and it’s the most serious symptom.

What Causes Dupuytren’s Contracture?

There are no known causes of Dupuytren’s contracture. Instead, doctors and researchers believe your genetics play a big role. This condition often runs in families. This means that if you have a parent, sibling, or grandparent with Dupuytren’s contracture, you’re more likely to develop it yourself.

Mayo Clinic has found that men of northern European descent seem to be affected more than other ethnic backgrounds. There are also certain health conditions and other factors that raise your risk of Dupuytren’s contracture, including:

• Diabetes — A disease caused by high blood sugar levels
• Vascular disease — Affects how well your blood vessels work
• Epilepsy — A seizure disorder
• Alcohol and tobacco use — Also affect your blood vessels
• Older age — People tend to develop Dupuytren’s contracture at 50 years or older.

Is Dupuytren’s Contracture More Common in People With Lupus?

Currently, there isn’t research showing that Dupuytren’s contracture and lupus are connected. Dupuytren’s contracture tends to affect men more often than women. However, women account for 90 percent of lupus cases.

There are only a handful of case reports discussing people with both conditions. For example, in an article from the journal Anais Brasileiros de Dermatologia, a doctor reported that a woman with discoid lupus erythematosus (DLE) and diabetes had Dupuytren’s contracture.

MyLupusTeam members have also shared that they have Dupuytren’s contracture. One member said, “I’m developing it now. My ring and pinky fingers on both hands are curled in, and I have nodules on the knuckle pads of almost all of my fingers. I’m waiting to see my doctor for a firm diagnosis.”

Another member shared their experience and wrote, “I’ve been diagnosed with Dupuytren’s disease. It isn’t quite a contracture yet, but it’s getting there. I can feel the bands in my palms, and my fingers and joints are often stiff. This was actually one of my first diagnoses that led me to look for possible autoimmune involvement because I was diagnosed as a woman in my 30s with no family history.”

Scleroderma, Dupuytren’s Contracture, and Lupus

Dupuytren’s contracture may be connected to other autoimmune diseases that affect people with lupus. Scleroderma is a connective tissue disease that affects your skin and other organs. Your connective tissue supports your cartilage, tendons, and skin and holds them in place.

Like lupus, scleroderma is an autoimmune disease. This means that your immune system mistakes your healthy tissues as foreign. It creates extra inflammation that triggers your body’s healing processes to make too much of the protein collagen.

Studies show that systemic (bodywide) sclerosis can affect the hands and may lead to contractures. Scleroderma can be associated more with people who have other autoimmune diseases like lupus and rheumatoid arthritis (an inflammatory joint condition) than with the general population. If you have both lupus and scleroderma, you can talk to your doctor about your risk of contractures.

How Is Dupuytren’s Contracture Treated?

MyLupusTeam members have asked others about their experiences with treatments. “Has anyone had Dupuytren’s contracture before and had the surgery? Has it helped or come back? I’ve gotten injections, but it’s getting bigger.”

Here, we’ll break down the different treatments for Dupuytren’s contracture. Your treatment plan will depend on your symptoms.

Treatments for Mild Symptoms

If you’re still able to use your hand for daily tasks and you don’t have any pain, your doctor may hold off on medical treatment and just recommend physical therapy to prevent progression. Treatments for mild symptoms include:

• Stretching exercises (which can also help relieve pain from lupus)
• Hand physical therapy
• Corticosteroid injections to treat pain and flatten new cords or nodules
• Splints or braces to help stretch your fingers to their normal position
• Heat or sound wave (ultrasonic) treatments to help make the tissues in your hand more flexible

Treatments for Moderate or Severe Symptoms

If your symptoms haven’t improved after trying these treatments, your doctor may recommend needling, injections, or surgery. With needling, your doctor will numb your skin and insert a needle into the cord. The tissue breaks and releases your finger so you’re able to move it. Needling may need to be repeated if your contracture develops again.

Collagenase injections are also useful for treating Dupuytren’s contracture. Collagenase is an enzyme that breaks down the protein collagen. It’s used to soften nodules and cords underneath your skin.

Your doctor will numb the affected area and inject the collagenase. After a few days, your doctor will move your hand in a certain way to break the softened cords or nodules. The effects of collagenase injections can last several years.

Severe cases of Dupuytren’s contracture may need surgical treatment. A fasciotomy is a surgery that removes the fascia or tissue in your hand that’s causing your symptoms. This is an outpatient surgery, meaning you get to go home once it’s done. Afterward, you’ll likely go to physical therapy to help regain your strength and range of motion (how far you can move your fingers). It’s important to know that all these therapy options are not permanent and that the contracture could reappear if the risk factors continue.

Treatment Considerations With Lupus

If you have both Dupuytren’s contracture and lupus, you’ll want to work closely with your doctors and rheumatologist. They can go over what you need to know about your treatment plan.

If you need surgery, talk to your rheumatologist and surgeon about how you’re managing your lupus before the procedure. If you’re in the middle of a flare, it’s best to wait until it’s under control to avoid complications. Surgery can also trigger a lupus flare — your rheumatologist can help you make a plan in case this happens.

You may also need to stop or change some of your lupus medications before surgery, especially corticosteroids and drugs that affect your immune system. Your rheumatologist can help you taper off a drug or adjust your dose as needed.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Are you living with both Dupuytren’s contracture and lupus? Share your experience in the comments below, or start a conversation by posting on your Activities page.