Vasospasm after Collagenase Clostridium Histolyticum Infiltration in Dupuytren’s Contracture

Abstract

Treatment with collagenase clostridium histolyticum has been shown to be effective at the short- and mid-term against Dupuytren’s contracture in which cords have formed. As with any new drug, pharmacovigilance studies will allow for reporting new complications with the treatment. We present a clinical case of vasospasm after collagenase clostridium histolyticum infiltration in a patient with a 60º affectation of the proximal interphalangeal joint forming an ulnar cord of fifth radius in the left hand. Evolution at one year presents the cord in the same contracture as before, and no vascular alteration. In our opinion, most complications from infiltration with collagenase clostridium histolyticum take place when the treatment is performed and are due to extravasation of the infiltration into healthy tissue. In cases of greater extravasation, vessels may be affected causing transient vasospasms due to the local action of the enzyme, together with a secondary inflammatory reaction to the collagenase action.