Tag Archives | scar tissues

Skin Thickening Disease on a Thicker View

Not everything that glitters is gold, and not everything that’s bigger and thicker is good. A skin that’s extraordinarily thick, which is commonly accompanied with one or more worse symptoms, is alarming.

Scleroderma – the skin thickening disease – is an autoimmune disease involving the connective tissue/s. One’s immune system behaves abnormally and overly active, that it attacks its own cells – thus, the term, autoimmune. Aside from skin thickening, the disease also features spontaneous scarring, blood vessel affectation, inflammation, and damages to internal organs such as the esophagus, kidneys and lungs. Truly, beauty is not the only thing which is skin deep, scleroderma too.

Skin Thickening Disease on a Thicker View

This skin thickening disease is classified according to the degree and location of the skin and organ involved. Currently, it has been categorized into localized scleroderma and systemic sclerosis or widespread. The latter is further divided into either limited or diffused forms based upon the extent of skin involvement. In both categories, overactive immune cells attack body cells and form scar tissue or fibrosis in the skin or on the internal organ affected. Scar tissue may form haphazardly that it leads to thickness and firmness of the involved organ.

What causes scleroderma is an FAQ. Like most autoimmune diseases, the long-awaited answer is still far unknown. But brilliant researchers have identified the potential causes, and even risk factors. Some evidence has associated the skin thickening disease with genes. A study for Choctaw Native Americans showed that this race has a high prevalence for the disease. However, environment still seems to take a major role as it contains most of our body’s stressors. When an individual becomes susceptible, his immune system is activated – but in a more intense manner – thereby damaging tiny blood vessels and injuring tissues leading to scar formation and collagen accumulation. This process continues until thickening and other worse symptoms appear!

These signs and symptoms will then be the reference for classifying the disease. Localized scleroderma includes skin changes in isolated areas. These can be morphea patches – hardened and slightly pigmented multiple skin lesions, or linear scleroderma – localized and hardened skin patches usually at the lower extremity. Sometimes, the latter is accompanied with a ‘satellite’ lesion, such as on the abdomen.

Whilst localized type involves only the skin, the diffuse form may afflict important internal body organs. It includes symmetric skin thickening of the extremities, face and trunk that can quickly proceed to hardening after the inflammatory phase. With this fast pace type, organ affectation may occur early and seriously, such as scarring of the lungs, esophagus, heart and kidneys. Elevation of blood pressure is definitely a danger sign and may lead to kidney failure.

The limited form of scleroderma is not that limited at all. There might be lesser skin involvement but remains as serious as the diffuse form. Its characteristic manifestation pattern is better known as CREST, or Calcinosis (tiny calcium deposits on the skin), Raynaud’s phenomenon (spasm of tiny arterial vessels due to heat or cold), Esophageal (weaker lower esophagus leading to acid reflux from the stomach), Sclerodactyly (localized thickening and tightness of the skin of the fingers and toes), and Telangiectasis (tiny red portions on the face, hands and mouths which blanch when pressed). Patients may have symptom variation of CREST and worse, may overlap to a diffuse form of this skin thickening disease.

Skin Thickening Disease on a Thicker View

Patients are diagnosed according to the signs and symptoms present and verified with a blood test that suggest autoimmunity and presence of antinuclear antibodies (ANA). Anticentromere antibody can be found on limited form and Anti-Sci 70 antibody for diffuse scleroderma.

Can it be treated? A universal treatment has not been identified yet, but sign/symptom – directed method has been used, especially for those life threatening manifestations. Indeed, this skin thickening disease is still a thicker and bigger challenge both for its patients and medical scientists.

Comments are closed

Dupuytren’s Contracture of the Hand: Facts at Hand

Oftentimes, people take our poor hands for granted, not realizing how much and how many ‘they’ can do. Being unable to grasp, grip, or hold something can be a horrible experience. And these are really true for people suffering with Dupuytren’s contracture of the hand.

Dupuytren’s disease or Dupuytren’s contracture of the hand is a fixed flexion of the hand, usually the ring and pinky fingers towards the palm. Why does it happen? Usually an autoimmune disease, immune system cells over actively behaves, attacking own cells leading to scar tissue formation or fibrosis. These scar tissues form a thickened, shortened cord that forces some of the fingers to curl inwards towards the palm, creating the hand deformity.

Dupuytren’s Contracture of the Hand: Facts at Hand

Also called a Viking Disease, legends say that Vikings spread the disease throughout Europe and Scandinavia hundreds years ago. Fact or myth, the disease really has a higher incidence rate in European countries such as Norway, Scotland, Iceland and Australia – where the Viking ancestry is predominant.

But it was until 1600 that the disease had been fully described by Swiss Doctor Felix Platter. Although this was recognized, it was still French Surgeon Baron Guillame Dupuytren who acquired the name of the disease for successfully initiating the operation for the retracted finger in 1831.

Decades have past but still the issue on what exactly causes Dupuytren’s contracture of the hand is still a big question mark. However, it is mostly associated with genes and family history. 60-70% of incidence runs in families. Men after age 40 are closely at risk, more so, those with North European/Viking ancestry. Trauma, diabetes, epilepsy and liver disease are also identified factors but still unexplainable. Meanwhile, smoking and alcoholism are sure precipitating factors as they affect blood circulation and tissue oxygenation – the less oxygen our tissues could get the higher chances of abnormal immune responses!

Most of the time, small, painless nodules in the palm are the first clinical signs. These nodules may begin to merge and become a more obvious lump on the skin. On later stages, the skin and underlying fascia contracts, including some fingers bent inwards, causing impairment of the hand and finger function. All fingers may be involved but most commonly the ring and little fingers are affected. Whilst nodules progression is rapid, the changes resulting to symptoms can be very slow. Thus, most of the time, patients would only seek consultation at its later stage, and shall be diagnosed through the table top test. Inability to place the hands, with the fingers, completely flat at the table renders a positive result.

Dupuytren’s contracture of the hand can be less painful, but it can be a nuisance in hand-involved activities. When this happens, medical treatment is initiated. The needling technique and the enzyme injection procedure both involve puncturing the cord and breaking it apart, to release the flexion. Although, these are non-invasive, recurrence is highly possible. For long term and hopefully lifetime treatment, surgery is advised. However, rehabilitation and physical therapy may also take a longer time.

Dupuytren’s contracture of the hand may be hereditary, but preventing its initiation and progression by protecting it from any kind of trauma, depends entirely at our hands!

Comments are closed

Fibromatosis Hand

Unusual hand curvatures and abnormal hand flexion, these can all be caused by fibromatosis. A broad medical term, fibromatosis includes a group of ‘mutated’ cells, producing a scar tissue with a distinct biologic behavior. Oftentimes, this is related to an auto-immune disorder, where the body’s own immune system destroys or damages own cells. Although considered benign or localized, the scar tissues have infiltrative growth, thus forming tumor-like lesions and have a tendency towards recurrence. What happens with fibromatosis at your hands?

Fibromatosis hand or palmar fibromatosis is medically called Dupuytren’s disease or contracture. Commonly affecting the hands of adults aged 50 and above, thick cord-like structures or lesions form at the palm of the hand causing the fingers to bend down slowly towards the palm. Definitive diagnosis for this is the table top test. With this, the patient places his hand flat on the table. If the hand cannot lie completely flat on the table with a space from the hand to table is as big as the diameter of a ballpoint pen, then the test is positive and treatment may be required.

Fibromatosis Hand

However, treatment of the disease can be delayed as symptoms occur very slowly and possible causes are not yet identified. Risk factors such as age, family history, a North European race, diabetes, smoking and alcohol use may increase chances of having it. Once positive, treatments are then based on its severity. Mild cases – those that do not impact one’s hand abilities – can do home remedies which are aimed towards avoiding or minimizing hand flexion. Meanwhile, severe cases are encouraged whether to undergo enzyme injection, needling, or surgical procedures to remove or puncture the cord-like formation.

Fibromatosis Hand

Dupuytren’s disease is fibromatosis at your hands! One’s genes might make you at risk of having it, but ‘loving’ your hands and ‘using’ it wisely, plus a healthy lifestyle, hold the definite key to avoid the disease, and even other fibromatosis!

Comments are closed