THE PRESENCE OF MYOFIBROBLASTS IN THE DERMIS OF PATIENTS WITH DUPUYTREN CONTRACTURE - A POSSIBLE SOURCE FOR RECURRENCE

Samples of skin and underlying cord obtained at dermofasciectomy for D upuytren's contracture have been examined for the presence of smooth m uscle alpha-actin (SM alpha-actin), a marker for myofibroblasts. 15 of the 20 samples stained positively for SM alpha-actin corresponding wi th areas of hypercellular Dupuytren's tissue. In 12 of these 15 sample s SM alpha-actin-positive hypercellular Dupuytren's tissue extended in to the dermis, in three cases reaching the epidermis. In eight samples , diffusely distributed cells positive for SM alpha-actin and resembli ng fibroblasts were seen in the dermis. These cells appeared to be sep arate from the Dupuytren's foci. The presence of hypercellular foci an d isolated fibroblasts positive for SM alpha-actin within the dermis m ay explain the high recurrence rate of Dupuytren's disease after fasci ectomy.