We have previously shown that Dupuytren’s disease is a low-grade localised inflammatory disorder and the myofibroblast phenotype characterised by expression of α-SMA and collagen type I, and contractility is critically dependent on the production of low concentrations of TNF locally.15,16 It is possible that the intermittent local administration of a relatively high dose of adalimumab could be sufficient to significantly affect the relatively small pool of cycling myofibroblasts14 or promote myofibroblast apoptosis. This evidence concerns the gene TNF and Dupuytren Contracture.