Palmar fasciitis is a rare condition characterized by thickening of the palmar fascia (the tissue in the palm of the hand), often leading to progressive flexion deformities of the fingers. It is frequently associated with underlying malignancies.
Key Characteristics of Palmar Fasciitis:
- Rare Condition: Palmar fasciitis is not commonly encountered.
- Palmar Fascia Thickening: The primary feature is the abnormal thickening of the palmar fascia in the palm of the hand.
- Flexion Deformities: This thickening can cause the fingers to progressively bend towards the palm, resulting in flexion contractures.
- Association with Malignancies: A significant aspect of palmar fasciitis is its association with various cancers.
- Bilateral Involvement: Unlike Dupuytren's contracture which may affect only one hand initially, palmar fasciitis typically affects both hands and all fingers.
- Similar to Dupuytren's Contracture: The symptoms resemble Dupuytren's contracture, but palmar fasciitis often presents with more widespread and rapid progression.
Palmar Fasciitis vs. Dupuytren's Contracture:
While palmar fasciitis shares similarities with Dupuytren's contracture, some key distinctions exist:
| Feature | Palmar Fasciitis | Dupuytren's Contracture |
|---|---|---|
| Prevalence | Rare | Common |
| Malignancy Link | Strong association with cancer | Generally not associated with cancer |
| Hand Involvement | Typically bilateral (both hands) and more diffuse | Can be unilateral (one hand) or bilateral, often localized |
| Progression | Often rapid | Usually slower |
Clinical Presentation:
Patients with palmar fasciitis often present with:
- Thickening of the skin and underlying tissue in the palm.
- Pain or discomfort in the palm.
- Progressive difficulty straightening the fingers.
- Nodules or cords in the palm.
Diagnosis:
Diagnosis typically involves:
- Physical examination of the hand.
- Imaging studies (e.g., MRI) to assess the palmar fascia.
- Ruling out other conditions, such as Dupuytren's contracture.
- Investigation for underlying malignancy.
Treatment:
Treatment focuses on managing symptoms and addressing any underlying malignancy:
- Medical Management: Addressing the underlying cancer if present.
- Physical Therapy: Exercises to maintain finger mobility and reduce contractures.
- Surgery: In severe cases, surgery may be considered to release the contracted fascia.
In summary, palmar fasciitis is a rare condition marked by palmar fascia thickening, finger flexion deformities, and a strong association with underlying cancers. It should be distinguished from Dupuytren's contracture, especially when it presents bilaterally and progresses rapidly.
