<prompt> All are true of Dupuytrens contracture except -Usually 4th finger is involvedBilateral disease is rareSurgical release is usefulMay be associated with Pyronie disease  <response>: Often both hands are affected Bilateral disease, one more than the other.The earliest sign is a small thickened nodule in the mid-palm opposite the base of ring finger.Gradually this extends distally to involve the ring or little finger.There is a rare, curious association with fibrosis of the corpus Cavernosum. 