A CLINICAL, ULTRASTRUCTURAL AND IMMUNOCHEMICAL STUDY OF DUPUYTRENS DISEASE

Aponeurotic tissue from seven normal subjects and from apparently unaf fected branches, nodules and cords of 16 Dupuytren's patients were com pared. Control tissue was characterized by polymorphous cells, showing cytoplasmic microfilament bundles, numerous pinocytic vesicles, basem ent membrane-like structures, and a thick coat of interwoven filaments , and by type I- and III-positive heterogeneous collagen fibrils, fibr onectin, vitronectin, decorin and proteoglycans. The clinically normal branches consisted of fibroblast-like cells, small type III-highly po sitive collagen fibrils, fibronectin and proteoglycans. Nodules and fi brotic cords contained fibroblast-like cells, type I and III collagen, fibronectin and proteoglycans. Myofibroblast-like cells in only five out of 16 patients were present. There was no relation between clinica l stage and structural alterations; the whole aponeurosis always seeme d to be involved; cord retraction would seem to depend on the interact ions among fibroblast-like cells and matrix components and among matri x macro-molecules themselves.