Sufferers of hand disease finding hope

Published: Friday, October 1, 2010 at 6:56 p.m.
Last Modified: Friday, October 1, 2010 at 6:56 p.m.

Heidemarie Mazza was facing the future with a clenched fist.


About Dupuytren's contracture

It most often affects the ring finger and pinky.

It occurs most often in older men of Northern European descent.

Ronald Reagan, Margaret Thatcher, playwright Samuel Beckett and pianist Misha Dichter were afflicted.

The FDA-approved drug Xiaflex is a treatment, though it costs $3,000 an injection, but that's less than the $15,000 price tag for hand surgery.

The 63-year-old Fort White resident is one of hundreds of thousands of Americans affected by Dupuytren's contracture, and it was making her life pretty miserable.

A hand deformity that usually develops slowly, over decades, Dupuytren's contracture affects the connective tissue under the skin of the palm.

Around the age of 54, Mazza noticed knots of tissue forming under the skin at the base of her fingers. Eventually, the knots formed thick cords that pulled her fingers into a bent position.

Mazza, who worked in human resources at the Lake City Veterans Affairs Medical Center, no longer could straighten her fingers to work at the computer.

“I'd look down, and my little finger was hooked so badly that it was erasing everything as I typed,” she said.

She was forced to retire, then had to have her little finger amputated. But the contracture continued to spread to her other fingers as well.

Dupuytren's contracture most commonly affects the ring finger and pinky, and occurs most often in older men of Northern European descent, which has earned it the nickname “Viking's disease.”

Ronald Reagan, Margaret Thatcher, playwright Samuel Beckett and pianist Misha Dichter are among those who have been afflicted.

Mazza found the solution for her crippling hand condition in a newly approved drug called Xiaflex. The U.S. Food and Drug Administration approved it in February as a nonsurgical treatment for Dupuytren's.

Mazza was treated with Xiaflex by Dr. Vidya Jain, a North Florida hand surgeon with offices in Gainesville, Palatka and Lake City. Jain said he is the first in Gainesville to use the injections.

For Mazza, who already had lost one finger and undergone multiple hand surgeries, it has been a life-changing treatment. She received an injection on July 26 at Jain's Palatka office.

Xiaflex uses an enzyme called collagenase to break down collagen, a major component of the body's connective tissue. Collagen builds up in excess in Dupuytren's patients, forming the cord that permanently bends the finger.

Twenty-four hours after her injection, Jain said, he was able to manipulate Mazza's fingers and break the disfiguring cords.

When she meets someone today, Mazza can reach out to them with an open hand.

The injections are not inexpensive. Jain said a single injection would cost around $3,000 but compares that with the $15,000 price tag for hand surgery. It is covered by Medicare and most insurance, he said.

Mazza is thrilled. She said she's particularly happy she can tell her two brothers, both of whom have the hereditary condition, that there's a solution short of surgery for Dupuytren's contracture.

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