Q. My husband has trouble straightening the fingers on his right hand due to Dupuytren’s disease. We would like to know more about the condition and what can be done.

A. Dupuytren’s disease may sound obscure, but it affects more than a million people in the UK and can lead to a significant loss of hand function, according to GP and television presenter Dr. Christian Jessen. He is campaigning for earlier diagnosis and treatment of this ‘worryingly’ common condition. ‘The longer it’s left, the more difficult it becomes to correct, so people may be left with severe and permanent consequences,’ he warns.

Dupuytren’s is caused by the build-up of cells in the palm, leading to small lumps under the skin. If the disease progresses, scar tissue composed of collagen builds up, forming a cord under the skin from the palm into one or more fingers. This gradually tightens and pulls the fingers towards the palm. ‘Left untreated, the fingers can become stuck and unbending, so you can’t perform simple tasks such as fasten a button, use cutlery or even shake hands,’ explains Dr Jessen.

The cause is unknown, but it seems to be hereditary in nearly 70 per cent of cases. It is much more common in men and in those with Northern European ancestors, which has led to it being nicknamed ‘the Viking disease’. Dupuytren’s is also linked to smoking, drinking alcohol and diabetes as well as heavy manual labour and injury. Repeated impact on the hands is another likely factor; cricketers including David Gower, Graham Gooch and Jonathan Agnew all suffer. Other people with Dupuytren’s include actor Bill Nighy and novelist Joanne Harris. Frank Sinatra and Margaret Thatcher were also affected.

Dr Jessen urges anyone with lumps, pitting or thickening of the skin of the palm or trouble straightening their fingers or palm to see their GP immediately.

Treatment options include surgery where the affected tissue (the cord) is cut or removed so that the fingers can be extended. Depending on the procedure, patients may have a local or general anaesthetic, either with daycare or a short hospital stay.

‘Another option is intralesional therapy, which involves injecting the cord with steroids or enzymes that dissolve the collagen; the cord may then break on its own by the next day. If not, the doctor extends the finger causing the cord to break,’ Dr Jessen adds.

It is possible that the problem will recur. If this happens, patients should see their doctors for advice on the most suitable treatment. For more information, visit thisisdupuytrens.com

If you succumbed to one of the virulent lurgies this winter, chances are you have ended up with long-running catarrh. Pharmacist Shabir Daya recommends two natural products by A Vogel – Bronchoforce (£9.75 for 50 ml), with ivy and thyme plus liquorice root, and Sinuforce Nasal Spray (£7.35 for 20 ml), with menthol and eucalyptus to clear a blocked nose. Both are available from victoriahealth.com.

Several readers have mentioned the topic of bed or chair-bound older relatives developing urinary tract infections (UTIs), such as cystitis. This can be painful and distressing and sometimes leads to hospital stays, as in the case of one of my family. The problem is basically due to germs getting stuck in the kidneys, which is more likely if the person is not moving around much. It’s worth noting that a UTI can cause dementia-like confusion in older people. One supplement that may prevent infections taking hold is Bio-Kult Pro-Cyan (£16.99 for 45 capsules, victoriahealth.com), a
triple-action formula with cranberry extract, live ‘good’ bacteria and immune-supporting vitamin A.

NB Always consult a doctor first if the person is on any medication, in case of interactions.

BOOK OF THE WEEK: The Itchy-saurus by Rosie Wellesley (Pavilion Children’s Books/£6.99)

The author, who is a GP, created this picture book when her own child developed eczema. Itchy-saurus is a dinosaur with red, itchy scales that make him angry. He eventually finds a remedy that soothes the itch and leads to a change of heart. Perfect for the 20 per cent of children with eczema. To order a copy for £5.94 (a 15 per cent discount) until 4 March, visit you-bookshop.co.uk or call 0844 571 0640; p&p is free on orders over £15.

Photo by Michael Carnevale on Unsplash

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