Review: Dupuytren's disease in Asia and the migration theory of Dupuytren's disease.

BACKGROUND

The presentation of a Chinese patient with unilateral Dupuytren's disease (DD) prompted a literature search and a review of the epidemiology of DD in the Asian population as it has never been cumulatively reported. The purpose of this paper is to review all the reported cases of DD in the literature and aetiological links to DD elsewhere.

METHODS

The literature was searched with a wide variety of terms, and subsequent references were analysed and further references investigated for other reported cases of DD in the Asian population.

RESULTS

This review found 595 cases and has shown that DD is present to a variable extent in China (96 cases), Thailand (19 cases), Vietnam (one case), India (15 cases) and Japan (474 cases). A total of 54% had bilateral disease. Risk factors (diabetes, trauma, epilepsy, alcoholism, manual labour) were reportedly present in 65% of the patients, and a positive family history was reported in 9%. The average patient age was 67 years.

CONCLUSION

This review shows that there is a low but significant incidence of DD across Asia, which supports the hypothesis of a widespread genetic susceptibility to the disease. Therefore, the prevalence of DD in this community is not likely due to sporadic genetic mutation as previously presumed but rather individual genetic susceptibility and that risk factors play a major role in the expression of DD in this population.