Morbus Dupuytren/Morbus Ledderhose

The digitopalmar contracture named after Guillaume Dupuytren (1832, 1834) [36, 37] and the corresponding digito-plantar contracture named after Georg Ledderhose (1897) [91] are fibrous, proliferative hyperplastic disorders of pre-existing connective tissue structures of the fascia of the fingers and palm or the toes and sole, respectively. However, in Morbus Dupuytren (MD) and Morbus Ledderhose (ML), the digitopalmar and digitoplantar changes are not just singular afflictions, but part of a systemic connective tissue disorder [41], which is confirmed by subtle biochemical changes and obvious ectopic fibrous deposits, which are located, for example, above the dorsal proximal interphalangeal joints (= knuckle pads), on the auricular helix, the hand wrist, the elbow and inside the penis (= Morbus Peyronie). These tissue changes are histologically identical, but all efforts to identify a single cause of this generalized disorder have failed, and numerous hypotheses about the disease onset and progression have been published, but a simple and straightforward explana tion is still missing.