Authors
1
Plastic and Reconstructive Surgery, Ismailia Medical Complex, Ismailia, Egypt
2
Plastic and Reconstructive Surgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
3
Pathology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
4
Plastic and Reconstructive Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt
5
Plastic and Reconstructive Surgery, Military Medical Academy, Cairo, Egypt
Abstract
Background: Fibroproliferative disorders include Dupuytren's contracture, which involves the palm of the hand, causing flexion contracture deformity of the fingers and functional limitations. The exact pathogenesis of this disorder remains questionable; past studies claimed that myofibroblasts are the cells responsible for Dupuytren's contracture. Despite having no complete cure for Dupuytren's contracture, different treatments are available. Objective: To determine the histopathological origin of Dupuytren's cord, either from the deep dermis or from the palmar fascia. Patients and Methodology: This prospective clinical study included twenty patients. We operated on fingers starting from 30 degrees of contracture, with the median preoperative flexion contracture degree being 67.1 (range 30.8-164.1). They all underwent dermo fasciectomy and pathological analysis of diseased tissue by H&E and immunostaining. Results: The results of this study were based on an H&E stain examination, where we found all dermal slides (100%) stained positive. Eight dermal slides (40%) were positive stains. Also, 15 subcutaneous slides (75%) were positive. By immune stain examination, we found that all fascial slides (100%) were stained positively. Seventeen subcutaneous slides (85%) were positive stains. Also, 12 dermal slides (60%) were positive, ranging in severity from five upper dermis slides (41.66%) to seven lower dermis slides (58.33%). Conclusion: Abnormal alpha-smooth muscle actin positive in both the palmar fascia and dermis, even the upper dermis. It is undeniable that the skin plays a part in etiology and recurrence.
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