What Causes Viking Disease And How Does It Develop?

Panaimaram

Going by what history has to say, a disease that involves a slow thickening and tightening of the skin tissues of the hand originated with the Vikings and hence the name Viking disease, which, otherwise, technically is termed as Dupuytren's contracture.

Viking disease is a hand deformity where the fingers bend towards the palm and cannot be extended outwards completely. This is a fixed flexion contracture that occurs due to palmar fibromatosis.

The disease affects the palmar band that leads to the contraction of the fingers gradually. Knots of tissue appear to form below the skin of the hand that appear as thick cords gradually that eventually pull fingers inward into a bent position.

Pathological findings indicate that the occurrence of this disease is associated with a thickening inside the palm, mostly on the ulnar side of the hand, ideally between the fourth and fifth metacarpal bone.

This disease could give you a tough time in managing daily chores such as working and washing.

The medical terminology used for this kind of a hand deformity is Dupuytren's contracture. However, it is referred to by commons as Viking disease. It is believed that this hand deformity originated with the Vikings and they spread it in Northern Europe and far beyond as they married the locals when travelling around the world.

It has been understood by several scientists and doctors that Dupuytren's disease is a common hereditary disorder. It is mostly found to occur in men who are over the age of 45 years. However, having this disorder in your genes doesn't necessarily guarantee the occurrence of this disease in you. This disease is found to be common among people who already suffer from epilepsy, alcoholism or diabetes.

This disease progresses gradually. Initially, the fibrous tissues in your palm would begin to thicken followed by tightening. The fingers would slowly begin to stiffen and then bend. The fingers also show loss of flexibility. The fingers that are affected cannot be straightened fully. You will slowly find it difficult to put on gloves, shake hands or place your hands inside your pocket.

Most of the time it is seen that this disease begins by affecting the ring finger first. The thumb and index finger are rarely affected with this disease. This disease slowly progresses over the years. The lump formed beneath the skin might be too sensitive to touch, but most of the time, it is not painful in nature.

The feel and look of your hands would be sufficient for your doctor to reach a conclusive diagnosis of this disease. Tests might rarely be required. Most cases show that this disease affects just one hand (although there could be cases wherein both the hands have this disease).

The doctor can compare both your hands and get an idea about how far this disease has progressed. The doctor would check for puckering on the skin. Toughened knots can be determined by pressing different parts of the hands. Pressing the fingers also helps the doctor in understanding the severity of the bands of tissues formed.

Physical examination might also involve your doctor asking you to place your hand on the top of a table as flat as possible. If you are unable to completely flatten your fingers, this would indicate the presence of Dupuytren's contracture.

The treatment required depends on how severe the condition is. Your doctor would be the best person to advise whether nonsurgical ways are available to treat your condition.

The primary goal of the treatment would be to eliminate the disability caused by the disease. However, if the condition has worsened beyond repair, then there might be no treatment available at all.

• Stretching: Mildest forms of this disease can be cured through stretching programs.

• Steroid injections: Anti-inflammatory medications may be injected into the affected area. There is a requirement of multiple injections at the site of the nodule.

• Enzyme injections: A mixture of enzymes, collagenase Clostridium histolyticum, is recommended if there is already a contracture. This can be helpful in breaking the tough tissues. Stretching exercises usually follow these injections.

• Radiation therapy: Low energy radiation therapy helps in prevention of condition worsening.

• Vitamin E cream and splinting might also be helpful in treating the condition to some extent.

If you find it extremely difficult to maintain your condition wherein you are unable to perform daily tasks, surgical intervention might be recommended.

• Open surgery: An incision is made and the thickened band of tissues are either divided or removed. A skin grafting can then be performed.

• Needle Aponeurotomy: Hypodermic needles can be used to divide and then cut the affected tissue. Recovery is quicker with this procedure.

பனைமரம் - Panaimaram