Dupuytren’s Contracture – Skin Nodules & Palm Thickening Diagnosis in London

Understanding Dupuytren’s contracture and skin involvement

Dupuytren’s contracture is a chronic condition that causes the connective tissue under the skin of the palm to thicken and tighten. Over time, this process pulls one or more fingers into a bent position, most often affecting the ring and little fingers. While it is classified as a fibromatosis of the palmar fascia, the skin is frequently involved, showing puckering, dimpling, and adherence to the underlying cords. These skin changes are not only cosmetic but also functional, limiting the smooth movement of the fingers.

Causes and risk factors

The exact cause of Dupuytren’s contracture is unknown, but genetic predisposition is strongly linked. Risk factors include:

• Genetics: Family history is one of the most important predictors.
• Age and sex: More common in men over the age of 40.
• Ethnicity: Higher prevalence among people of Northern European descent.
• Associated conditions: Diabetes, epilepsy, and liver disease may increase risk.
• Lifestyle factors: Smoking and heavy alcohol use are linked to higher occurrence.

Skin signs of Dupuytren’s contracture

Early indicators often involve the skin. Patients may notice small lumps or nodules in the palm that feel firm under the skin. As the disease progresses, skin puckering, dimpling, and visible cords become more obvious. These cords extend into the fingers, gradually pulling them downwards. The skin itself may appear tethered and inflexible.

Diagnosis

Diagnosis is typically made through clinical examination. A dermatologist or specialist will assess the hand, looking for nodules, skin puckering, and contractures. Imaging is rarely needed but may be used in uncertain cases.

Treatment options

Management depends on the severity and progression of symptoms. Options include:

• Observation: In mild cases where contracture is minimal and function is not affected.
• Injections: Steroid or collagenase injections may soften cords and reduce progression.
• Needle aponeurotomy: A minimally invasive procedure to divide cords under the skin.
• Surgical release: Reserved for severe cases with significant functional impairment.
• Dermatology care: Skin health support to manage dryness, scarring, or post-procedure recovery.

Recovery and aftercare

After treatment, physiotherapy is often recommended to restore mobility and strength. Skin care is equally important, as incisions or injections can leave sensitive areas prone to dryness or scarring. Dermatology-led support ensures optimal healing.

Dupuytren’s contracture in different groups

While it predominantly affects older men, women and younger individuals may also be affected. In skin of colour, nodules and cords may be less visible but still cause functional problems.

Why choose Skinhorizon?

At Skinhorizon, our dermatology team works alongside hand specialists to provide comprehensive support. We focus on the skin’s role in Dupuytren’s contracture, offering both medical and aesthetic strategies to preserve hand function and comfort.

Your first visit — what to expect

1. History: Review of hand symptoms, lifestyle, and family history.
2. Examination: Assessment of skin dimpling, nodules, and contracture severity.
3. Discussion: Explanation of treatment options, from monitoring to advanced care.
4. Plan: Creation of a tailored management strategy.
5. Follow-up: Monitoring to detect progression or recurrence early.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 20 August 2025