# Palmar Fascia Fibrosis in Dupuytren’s Disease: A Narrative Review of Pathogenic Mechanisms and Molecular Insights

## TL;DR

This review explores the causes and molecular mechanisms behind Dupuytren’s disease, a condition causing hand contractures and frequent surgical recurrence.

## Contribution

The paper integrates genetic, epigenetic, and signaling pathways to present a comprehensive view of Dupuytren’s disease pathogenesis.

## Key findings

- DD involves TGF-β and Wnt/β-catenin signaling, cytoskeletal changes, and immune-inflammatory processes.
- Epigenetic dysregulation maintains fibroblasts in a myofibroblast state, contributing to fibrosis.
- Variability in study results is attributed to disease stage and therapeutic approaches.

## Abstract

Dupuytren’s disease (DD) is a chronic fibroproliferative disorder of the palmar fascia, leading to disabling digital contractures and high recurrence after surgery. This narrative review highlights DD as a multifactorial condition in which genetic predisposition and cytogenetic instability converge with extracellular matrix remodeling, aberrant transforming growth factor β (TGF-β) and Wnt/β-catenin signaling, cytoskeletal stabilization and immune-inflammatory amplification. Epigenetic dysregulation further locks fibroblasts into a persistent myofibroblast state. Discrepancies between studies are largely explained by disease stage and experimental anti-inflammatory, antifibrotic and epigenetic strategies to achieve durable disease modification.