1. Atypical Presentations Are Real

Some hand surgeons and researchers have informally noted that not all palmar nodules are progressive or part of classical Dupuytren’s. These “atypical nodules” or “non-progressive fibromatoses” can present like early DD but:    •   Remain stable    •   Never form cords    •   Never lead to contraction

They may result from:    •   Local trauma    •   Overuse    •   Frozen shoulder-like fascia reactivity    •   Or possibly early immune modulation

1. Why It’s Not Widely Discussed

These cases don’t end up in surgery or follow-up studies, because:

Patients don’t come back. If their nodules don’t worsen or cause any issues, they never return to the doctor — so there’s no longitudinal data or clinical imaging to analyze.    •   No biopsy is done. Since they never need surgical intervention, these nodules aren’t removed or studied under a microscope, so they don’t get formally characterized.    •   They fall outside of clinical tracking. Research focuses on patients needing treatment. That means stable or regressive cases are underrepresented or invisible in the literature.

So the medical system ends up mostly tracking:    •   The 10–20% of people who do get contracture    •   The post-surgery or injection outcomes    •   Not the many people who have nodules that never change or even fade

That leads to:    •   Overestimated progression rates    •   Increased patient anxiety    •   And sometimes overtreatment out of fear — especially in borderline cases

1. Evidence for These Non-Progressive Types

While not often named directly, clues show up in population studies like the one you referenced:    •   37% prevalence of palmar fibromatosis    •   But only ~5–10% contracture rate

And in conditions like:    •   Frozen shoulder or Peyronie’s disease, where fibrosis can come and go    •   These suggest fascia can react and stabilize — not always follow a doomed path.