If you have small lumps or a lump in the palm of the hand below the middle finger, you most likely have contracted Dupuytren’s contracture. It is a condition that leads to formation of tissue knots under the skin of palm. Overtime, the skin of the palm will thicken and tighten. This will cause one or several fingers to curl or bend forward. If left untreated, the condition can lead to crippled hands.
In most cases a lump in the palm of the hand below the middle finger will appear. It will start as a nodule or a knot but later gain mass into a lump. Tiny pits also form under skin of palm. The condition is not painful. Both or either hand can be affected.
Causes of Dupuytren’s contracture
Experts are not sure as to what causes Dupuytren’s contracture. Whatever the cause may be, it has nothing to do with injuries to tendons or overuse. The chemical properties of the connective tissue are most probably affected by the causes of this condition. It tends to develop when the following risk factors are involved:
- Gender –fewer women than to men are diagnosed with the disease. However, men tend to develop more severe symptoms
- Alcohol – heavy alcohol consumption may encourage the disease. This doesn’t however mean that most alcoholics have the disease.
- Tobacco – any one or several of the many chemicals in tobacco smoke may interfere with chemical composition of the palms’ connective tissue.
- Age – most cases are reported in individuals above 50 years of age. The 40-60 years age bracket is mostly affected.
- Diabetes – diabetes is associated with many disorders and conditions, including Dupuytren’s contracture.
- Genetic factors – the disease tends to run in families
- Epilepsy medications
Enough evidence to associate any of the mentioned possible causes is not available. It is however agreed that manual work or operating machinery doesn’t encourage the disease.
Symptoms of Dupuytren’s contracture
Most patients will first notice thickening and tightening of the skin. This happens gradually over time. You may notice slight depressions on the palm with time. A lump, mostly below the middle finger, will appear after some time. It will not be painful but can be sensitive to touch.
Dupuytren’s contracture cords continue to form and extend to the fingers. The little finger and the ring finger are the most drastically affected. The middle finger can also be reached but rarely will the thumb be involved.
The cords that form from the disease are inflexible. This causes the affected fingers to curl forward as they are pulled by the cords. The end result is permanent bending of the affected fingers.
Diagnosis for Dupuytren’s contracture
You can compare with the many available lumps in palm of hand pictures at home. You can also check the symptoms to see if they correlate with the mentioned ones. All the same, diagnosis is best confirmed by a doctor.
No special tests are required for Dupuytren’s contracture diagnosis. Your doctor will only require to perform a physical examination. Lump in the palm of the hand pictures due to Dupuytren’s contracture can also help with diagnosis.
The common signs that will be checked for include:
- Thickened or tightened skin
- Bent pinkie and ring fingers
- Pitted palms
- Lump in the palm
The doctor will most likely compare the status of both your palms. You will be required to check if you can fully straighten your fingers by pressing them on a flat surface. Your ability to grasp items will also be tested.
Treatment for Dupuytren’s contracture
In most cases, Dupuytren’s contracture is only monitored but not cured. In fact, there is no cure for the disease. Monitoring the progress of the disease is very important although it rarely causes intolerable discomfort. To check its progress, place your hand on a flat surface and see the much you can succeed in keeping them straight. The following correction options can be considered:
Injectable medications that contain specific proteins or enzymes can be used. They work by weakening the cords that are pulling the fingers. More than one appointment will be required. The doctor will straighten your fingers for a couple of seconds to encourage breakage of the cords. A bit of swelling, pain and bruising will occur after the injection.
Radiation has recently been added to the list of considerable treatment options for Dupuytren’s contracture. It involves directing X-rays at the nodules under skin of palm. X-rays interfere with how collagen is formed. Collagen is the main constituent of connective tissues. This treatment requires a number of appointments, which are spread over weeks. It causes problems like skin dryness. It is also not guaranteed that it will work.
As the name suggests, this treatment involves puncturing Dupuytren’s contracture cords with a needle. The cords will most likely form again even after this treatment. In that case, the treatment will be repeated. Needling can be used in more than one affected finger. However, its use is limited on areas of the palm where tendons and nerves occur.
Surgery is considered for severe cases. It simply involves surgical removal of Dupuytren’s contracture tissue. This treatment option is highly successful and complete. It will however take longer to heal. A single incision is usually made to remove the tissue. If widespread, more than one small cut can be made on the skin. It is only in rare cases that both the overlying skin and the Dupuytren’s contracture tissue are removed altogether. Before surgery, make sure to ask your doctor the long recovery may take. If too long, you can always consider other treatment options.
When to see a doctor
Dupuytren’s contracture is a progressive condition. It may actually never get to a point of causing much discomfort. However, severe cases are potentially crippling.
Seek medical attention if you experience difficulty grasping objects, can’t keep your fingers straight for long or have more than one lump on your palm.
At home, you can try massaging the affected palms. Warm compress may also improve the condition a bit. Note that splinting or forcing your fingers to straighten will not cure Dupuytren’s contracture. In fact, it may encourage curling of the fingers more rapidly. Only corrective treatment options listed above can work for Dupuytren’s contracture treatment.
Other possible causes of lump in palm of hand
Eczema is characterized by red, itchy, dry and inflamed skin patches. Eczema doesn’t occur under the skin. It also doesn’t form a single lump. Rather, lesions develop on the affected skin patches. The lesions soon turn into blisters and ooze fluid or pus.
Psoriasis develops due to accumulation of dead skin layers which are naturally supposed to be shed off. It is a bit itchy but not like eczema. The affected skin will appear dry and scaly. Again, psoriasis will not form below the skin. It is also unlikely that the lump will be that large.
Cysts forms when fluid, gas, pus or some other soft material collects in a sac-like structure under the skin. It is not common to have one in the palm of the hand but can still occur. Cysts are of different types. For example, the ovarian cysts that may cause a lump on the right side of the stomach are a bit different from the ones that may occur on your palm. Much the same can be said about a cyst that will cause a hard lump on the penis. All form through a similar process however. They are in most cases painless and generally harmless. With time, they will disappear on their own.
A lump in the palm of the hand under the middle finger due to a benign tumor doesn’t require any special treatment. A good example of a benign tumor that can appear under the skin of palm is a lipoma. A lipoma is basically a fat nodule that can appear anywhere under the skin. It feels soft, tender and rubbery to touch. Lipomas are slightly movable when pushed. A fibroma can also develop on the connective tissues of the palm.
Malignant cancer tumors
The main difference between malignant tumors and benign tumors is the fact that the former will spread to other body parts. It is one of the features that make cancer tumors too hard to completely get rid of. Rarely will malignant tumors start on the palm of the hand. If that occurs, a hard lump will develop. Other signs of malignancy include:
- Lumps that increase in size
- Swollen lymph nodes
- Lumps elsewhere in the body such as hard lump on the testicle
- Voice hoarseness
- Unexplained weight loss
- Chronic cough
- Pain in the belly
See your doctor is such symptoms are to show up. You can also consider learning more on topics such as a lump on the labia, meaning of pea-sized lump in the breast, what does a testicular lump feel like and more.