Re-visiting Luck’s classification: a histological analysis of Dupuytren’s disease

Abstract

Luck (1959) described a histological staging system for Dupuytren's disease, classifying the disease into three stages. Previous biochemical and immunochemical studies have detailed the decrease in type III/I collagen ratio with disease progression. Herovici (1963) described a histological stain that produced a differential red/purple and blue colour for type I and III collagen respectively. We stained 15 specimens of Dupuytren's disease and quantified the different collagen types in each using computer analysis. We found a corresponding decrease in the amount of type III collagen as a percentage of the total collagen with disease progression: stage I range 35-49% (mean 38%); stage 2 range 21-33% (mean 27%) and stage 3 range 11-19% (mean 14%). We propose a new staging system based on the relative amount of type III collagen, where stage 1: >35%, stage 2: >20% and <35%, and stage 3: <20%.

Identification of Histological Patterns in Clinically Affected and Unaffected Palm Regions in Dupuytren's Disease

“…In this regard, our results demonstrated that DDC had significantly more collagen content than NPF and NFF as determined by picrosirius and Masson's trichrome staining, and that collagen fibers were highly organized and oriented only in DDC tissues, with an increase in the ratio of type III to type I collagen as compared to controls. The concentration of collagen fibers oriented in the same direction is one of the main factors related to the pathogenicity of this disease, in which contracture cords are predominantly composed of an oriented fibrous structure [32] mainly consisting of collagen fibers [12]. Our histological analysis also revealed that the amount of collagen fibers in NPF almost duplicated the amount found in control NFF, with the ratio of type III to type I collagen being similar in DDC and NPF.…”

Evaluation of Clinical Results, Histological Architecture, and Collagen Expression Following Treatment of Mature Burn Scars With a Fractional Carbon Dioxide Laser

“…6 This technique has been used to subjectively analyze keloid scars and Duputyren contractures. 7,8 The Herovici stain has been used to quantify the amount of types I and III collagen within mature burn scars, providing an objective analysis. 9 Despite anecdotal reports that ablative lasers improve scars, to our knowledge, no formal investigation has quantified improvement or possible underlying mechanisms.…”

Evidence-Based Medicine

“…Lam et al 11 added an analysis of collagen type to Luck's classification of Dupuytren disease. Fifteen surgical specimens were evaluated using collagen-specific stains to identify the relative percentages of type I versus type III collagen.…”