Hereditary Nature of Dupuytren's Contracture
Yes, Dupuytren's contracture is strongly hereditary with an autosomal dominant inheritance pattern, particularly affecting individuals of Northern European or Scandinavian descent.
Genetic Basis and Inheritance Pattern
Dupuytren's contracture demonstrates clear genetic transmission with the following characteristics:
- Follows an autosomal dominant inheritance pattern 1
- Most commonly affects men over age 60 of Scandinavian, Irish, or Eastern European descent 1
- Strong familial predisposition with positive family history being a significant risk factor 2
- Highest prevalence in North European populations or people of Viking descent 3
Risk Factors and Genetic Predisposition
Several factors increase the likelihood of developing Dupuytren's contracture:
- Male sex (higher prevalence than females)
- Advanced age (particularly over 55 years)
- Northern European or Caucasian ethnicity 4
- Positive family history of Dupuytren's disease
- Diabetes mellitus 2
Clinical Presentation and Associated Conditions
Dupuytren's contracture often presents as part of a broader genetic syndrome:
- May occur alongside other fibroproliferative disorders with similar genetic origins:
- Ledderhose disease (plantar fibromatosis)
- Garrod knuckle pads
- Peyronie's disease 3
- Disease progression tends to be more aggressive in cases with:
- Early age of onset
- Additional fibromatosis affecting the dorsum of hands, soles of feet, and penis 2
- Bilateral hand involvement
Injury-Related Dupuytren's Contracture
While hereditary factors predominate, trauma can trigger the condition in genetically predisposed individuals:
- Approximately 22% of Dupuytren's contracture cases may be injury-induced 5
- Injury-induced cases typically:
- Present at a younger age (mean onset 52 years vs. 56 years in non-injury cases)
- Progress more slowly (longer symptom duration)
- Present with less severe contractures (predominantly stage I-II) 5
- Even in injury-induced cases, patients typically express strong genetic predisposition toward developing the condition
Clinical Implications of Hereditary Nature
The hereditary nature of Dupuytren's contracture has important clinical implications:
- First-degree relatives of affected individuals should be informed about their increased risk
- Patients with family history may benefit from earlier screening and intervention
- Patients with Dupuytren's diathesis (genetic predisposition) have higher rates of recurrence after treatment 1
- Use of full-thickness skin grafts may be beneficial for patients with strong genetic predisposition to reduce recurrence 1
Conclusion
The evidence strongly supports that Dupuytren's contracture is a hereditary condition with autosomal dominant inheritance. While environmental factors like trauma may trigger or accelerate the disease in predisposed individuals, the underlying genetic basis remains the primary determinant of disease development and progression.