Superficial Dermal and Fascial Fibromatoses

Yvon, Adrien; Volk, Susan W.

doi:10.1016/b978-0-12-386456-7.04403-8

Cited by 1 publication

(4 citation statements)

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“…It progresses through proliferative, involutional, and residual phases, involving fibroplasia, nodule formation, and uncontrolled fibroblast proliferation triggered by local mediators. In the involution phase, cell rearrangement induces collagen synthesis, contraction, and subsequent contractures [ 5 ]. The residual phase witnesses the nodules regressing into thick cords, resulting in visible cords and severe contractures [ 6 ].…”

Section: Reviewmentioning

confidence: 99%

“…The myofibroblasts are predominantly composed of type III collagen and are influenced by cytokines such as interleukin-1 (IL-1) and transforming growth factor beta-1 (TGF-β1) [ 4 ]. The progression of Dupuytren contracture occurs in three phases: proliferative, involutional, and residual, with the proliferative stage characterized by fascial fibroplasia, nodule formation, and fibroblast proliferation [ 5 ]. Uncontrolled fibroblast proliferation, induced by local mediators, is implicated in nodule formation.…”

Section: Introductionmentioning

confidence: 99%

“…The reported prevalence of DD varies from 2% to 42%, influenced mainly by ethnicity, gender, and age [ 1 ]. Numerous studies [ 1 , 5 , 9 ] have consistently reported an age-related increase in the prevalence of DD, with a higher occurrence in males and individuals of Northern European descent. Surprisingly, a 2020 study identified the highest DD rate in Africa at 17.2%.…”

Section: Introductionmentioning

confidence: 99%

“…Studies that did not report outcomes of interest for the clinical question;(5) Studies that used other management approaches;(6) Studies other than original articles (RCTs, cross-sectional, prospective cohort, retrospective studies), case-control studies, case reports, and case series.…”

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confidence: 99%

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Comparing Complications and Patient Satisfaction Following Injectable Collagenase Versus Limited Fasciectomy for Dupuytren’s Disease: A Systematic Review and Meta-Analysis

Alhebshi,

Bamuqabel,

Alqurain

et al. 2024

Cureus

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Dupuytren's disease (DD) is a fibroproliferative disorder that manifests as an abnormal growth of myofibroblasts, causing nodule formation and contractures and affecting digit function. If left untreated, these contractures can lead to a loss of mobility and potentially impact hand function. This systematic review critically compares and evaluates the existing literature on the complications and patient satisfaction following injectable collagenase Clostridium histolyticum (CCH) versus limited fasciectomy (LF) for DD. We performed a comprehensive search of the PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), The Cochrane Library, and Excerpta Medica database (EMBASE) databases from 2006 to August 2023. This research targeted all clinical studies involving adults who underwent injectable collagenase and/or limited fasciectomy in the management of DD. Out of the 437 identified studies, only 53 were considered eligible for our analysis, and merely 14 met our inclusion criteria. These selected studies encompassed a total of 967 patients with 1,344 treated joints, with an average follow-up duration of 19.22 (ranging from one to 84.06) months. Within this cohort, 498 joints from 385 patients underwent LF, while 846 joints from 491 patients received CCH injections. Notably, among the 491 patients treated with CCH, 1,060 complications were reported, averaging 2.15 complications per patient, with the most common being contusion/bruising/hematoma/ecchymosis (22.54%), and edema/swelling (18.96%). In contrast, among the 385 patients treated with LF, only 97 complications were reported, translating to 0.25 complications per patient, with the most frequent being paraesthesia or numbness (23.7%), scar sequelae like skin laceration, tear, fissure, or hypertrophic scar (23.7%), and neuropraxia or nerve injury (22.6%). Our meta-analysis indicates that paraesthesia or numbness is more frequently observed in LF than CCH injections, although without statistical significance, with a risk ratio (RR) of 0.39 (95% confidence interval (CI) 0.13-1.18, p-value 0.1). However, scar sequelae (hypertrophic scar, skin laceration, tear, or fissure) show a contrasting pattern, being more commonly associated with CCH injections than LF, with an RR of 1.98 (95% CI 0.26-14.85, p-value 0.51), which, upon eliminating the source of heterogeneity, becomes statistically significant, with an RR of 4.98 (95% CI 1.40-17.72, p-value 0.01). Our data revealed a higher frequency of complications with CCH compared to LF, although more severe adverse effects were observed in the LF group, such as neuropraxia or nerve injury. Scar sequelae were more common with CCH injections. Despite both treatments showing increased patient satisfaction at the final follow-up, CCH injection resulted in earlier improvements in satisfaction.

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Section: Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%