What are the other Names for this Condition? (Also known as/Synonyms)

• Palmar Fascial Fibromatosis

What is Palmar Fibromatosis? (Definition/Background Information)

• Palmar Fibromatosis is a common condition that affects the soft tissues of the hands and fingers. It typically causes painless nodules in the volar aspect (palm) of the hand
• Palmar Fibromatosis is seen in adults, mostly men, over 30 years of age. The condition may affect both the hands. Over time, the appearance of multiple nodules that fuse together may be noted
• Surgical removal of the nodules through dermofasciectomy may be undertaken for severe Palmar Fibromatosis. The prognosis is generally good with treatment, although recurrence of the condition is known to take place

Who gets Palmar Fibromatosis? (Age and Sex Distribution)

• Palmar Fibromatosis is generally seen in middle-aged and older individuals; the incidence of occurrence increasing with age
• The condition is uncommon in individuals who are less than 30 years of age
• It is more common in males than females, with a male-female ratio of 7:2 being noted
• Individuals of north European descent have a higher risk for Palmar Fibromatosis

What are the Risk Factors for Palmar Fibromatosis? (Predisposing Factors)

Some of the risk factors associated with Palmar Fibromatosis include:

• Uncontrolled diabetes
• Alcoholism
• 5-20% of the individuals with Palmar Fibromatosis have plantar fibromatosis (condition in which the feet are involved)
• Positive family history: The condition may be seen in families, in some cases
• Some cases are known to be associated with trauma
• 1 in 25 individuals have penile fibromatosis (Peyronie’s disease)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Palmar Fibromatosis? (Etiology)

The cause of Palmar Fibromatosis formation is due to genetic mutations. However, the exact genetic mechanism causing the tumor is not yet identified. Currently, studies indicate the following defects:

• Gains on chromosome 7
• Gains on chromosome 8

The above genetic abnormalities can be detected using molecular studies, which may play a significant role in identifying the tumor type, and in some cases, helping the healthcare provider take appropriate treatment decisions.

What are the Signs and Symptoms of Palmar Fibromatosis?

In a majority of individuals, no signs and symptoms are present. In some, the following signs and symptoms of Palmar Fibromatosis may be noted:

• It is a benign skin condition that is generally painless
• The firm nodules form on the palm of the hand; half of the cases involve both the hands (bilateral condition)
• Multiple nodules may form over time, which then connect with each other to form bands
• Mostly, the volar aspect of hand is affected; rarely, the dorsal aspect (back of the hand) may be involved
• The skin may show puckering
• In advanced cases, it can cause shrinking of the palm and bending of the fingers causing Dupuytren’s contracture. At this stage, there may be pain in the affected hand(s)

How is Palmar Fibromatosis Diagnosed?

The healthcare provider may perform a thorough physical examination with medical history and other tests, to help diagnose Palmar Fibromatosis. Such a diagnosis would involve:

• Imaging of the affected region, such as CT/MRI scan of the hand
• Tissue biopsy: A biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Palmar Fibromatosis?

The possible complications from Palmar Fibromatosis may include:

• Pain, which can be severe and decrease the quality of life
• Very severe cases progress to Dupuytren’s contracture (a condition resulting in claw hand)
• Emotional stress
• Recurrence of the condition after surgery

How is Palmar Fibromatosis Treated?

Treatment measures for Palmar Fibromatosis may include:

• Initially, conservative methods are used to treat the condition, such as pain-relief medication, steroidal injections, etc.
• Surgery is usually performed, if the symptoms (such as pain) are intense
• Surgery may involve dermofasciectomy, which is a procedure to remove the fascia followed by skin grafting
• Use of cryosurgery on the nodules

How can Palmar Fibromatosis be Prevented?

There are no clearly established preventive measures for Palmar Fibromatosis. However, early detection and treatment of the condition may help individuals achieve a successful outcome.

Controlling the following risk factors may help reduce the incidence of Palmar Fibromatosis:

• Adequately control diabetes
• Avoid alcoholism

What is the Prognosis of Palmar Fibromatosis? (Outcomes/Resolutions)

• The prognosis of Palmar Fibromatosis depends on the severity of the condition. In general, the prognosis is good with adequate treatment
• However, recurrence of the condition after surgery is a possibility
  • The risk of recurrence decreases if dermofasciectomy procedure is performed to treat Palmar Fibromatosis
  • The risk of recurrence is more in those with bilateral condition (when both hands are affected)

Additional and Relevant Useful Information for Palmar Fibromatosis:

• Dupuytren’s contracture is a very common condition, unlike Plantar Fibromatosis that is very rare

The following article link will help you understand Dupuytren’s contracture.

http://www.dovemed.com/diseases-conditions/dupuytrens-contracture/