What’s making my finger joints curl?

Q FOR some time now when I read my daily paper my hands clamp like a fist around the pages and it can take some time to straighten them out again, which is painful. What is causing this and is there anything that can be done to stop it happening?

A CLAMPING of the ring and little fingers can be caused by thickening of the tissue in the palm of the hand, a condition known as Dupuytren’s contracture.

Initially there is just some lumpiness that can be felt in the side of the palm, but eventually the fingers start curling inwards, and it can be difficult to straighten them.

Difficulty straightening one finger can be due to a trapping of the tendon that causes it to curl inwards.

It can only be straightened with a characteristic snapping sound, also known as “trigger finger” and in more advanced cases it may only be possible to straighten the finger by physically doing this with the other hand.

This is unlikely, however, to cause both hands to stay grasped around your newspaper. If most of your fingers are involved then this may be a sign of arthritis in the finger joints, which can occur even if you do not have arthritis anywhere else.

I suggest you go and see your GP, who will be able to get to the bottom of the cause and hopefully arrange some sort of treatment.

Q COULD you explain what lichen sclerosus is and what is the treatment usually given for this condition?

A LICHEN sclerosus is a skin condition that can occur anywhere in the body, but most commonly affects the genital area. It can occur at any age, including childhood.

The skin becomes inflamed and looks red, then white, and also becomes thin and scarred.

It also feels itchy and sore, which means many women with it often initially think they have thrush.

Affected skin is very fragile and is prone to cracks, which can be very painful. These heal with scars, which may alter the structure of the folds of skin in the genital area.

It can make having sex very uncomfortable and, if the back passage is affected, it can cause severe constipation.

A doctor familiar with the condition can diagnose it just by its characteristic appearance but if there is any doubt, a biopsy can be done.

The exact cause is not yet known but it is thought to be an autoimmune condition, where the skin is attacked by the body’s own immune system.

Sufferers are more at risk of having other autoimmune conditions such as thyroid disease. It is treated with very strong steroid creams, which stop the inflammation.

Weak or moderate-strength creams do not work. Initially the cream needs to be applied daily for at least two months but once the inflammation has settled then the cream should be applied just often enough to keep it under control.

The inflammation may stop for months or years but it is one of those conditions that can flare up for no apparent reason, although slight trauma, such as just wiping yourself a little too hard with toilet paper, may trigger further inflammation.

Women with genital lichen sclerosus which has not been treated are at slightly increased risk of cancer of the vulva but this risk is considerably reduced with steroid treatment. However, anyone with lichen sclerosus who develops an area of skin that does not heal should see their doctor without delay.