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ORIGINAL ARTICLE
Year : 2008  |  Volume : 20  |  Issue : 3  |  Page : 94-99 Table of Contents   

Palmar dermatoglyphics in oral leukoplakia and oral squamous cell carcinoma patients


Department of Oral Medicine and Radiology, KLE'S Institute of Dental Sciences, Nehru Nagar, Belgaum, India

Date of Web Publication16-Jun-2009

Correspondence Address:
Elluru Venkatesh
Department of Oral Medicne and Radiology, Kamineni Institute of Dental Sciences, Narketpally, Nalgonda, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-1363.52774

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   Abstract 

Background and Objective: Dermatoglyphics are the dermal ridge configuration on the digits, palms and soles. They are genetically determined and influenced by environmental forces that are operating before birth. Several studies have shown association between dermatoglyphics and different types of cancer. Hence this study was undertaken to determine whether specific dermatoglyphic patterns exists which help in predicting the occurrence of oral squamous cell carcinoma (OSCC) and oral leukoplakia. Materials and Methods: Finger and palm prints were collected using Ink method from 30 subjects with OSCC, 30 subjects with oral leukoplakia and 30 healthy controls and were evaluated qualitatively and quantitatively. Results: Arches and loops were more frequent in cases than in controls whereas whorls were more frequent in control group ( P < 0.01). Conclusion: Our study concluded that dermatoglyphic patterns may have a role in identifying individuals either with or at risk for developing oral leukoplakia and OSCC. Hence can be used to identify high risk group, so that early primary and secondary preventive measures can be instituted in order to prevent the occurrence of these lesions.

Keywords: Dermatoglyphics, oral leukoplakia and oral squamous cell carcinoma


How to cite this article:
Venkatesh E, Bagewadi A, Keluskar V, Shetti A. Palmar dermatoglyphics in oral leukoplakia and oral squamous cell carcinoma patients. J Indian Acad Oral Med Radiol 2008;20:94-9

How to cite this URL:
Venkatesh E, Bagewadi A, Keluskar V, Shetti A. Palmar dermatoglyphics in oral leukoplakia and oral squamous cell carcinoma patients. J Indian Acad Oral Med Radiol [serial online] 2008 [cited 2020 Jan 29];20:94-9. Available from: http://www.jiaomr.in/text.asp?2008/20/3/94/52774


   Introduction Top


Dermatoglyphics is a relatively new science, which involves the study of fine patterned dermal ridges on digits, palms and soles. Cummins and Midlo (1926) coined the term dermatoglyphics (derma = skin; glyphics = carvings), for the scientific study of ridges as well as the ridges themselves. [1]

Widespread interest in epidermal ridges developed only in the last several decades when it became apparent that many patients with chromosomal aberrations had unusual ridge formations. Unusual ridge configurations have been shown to exist not only in patients with chromosomal defects but also in patients with single gene disorders and in some in whom the genetic basis of the disorder is unclear. [1]

Epidemiological and experimental evidence indicates a causal relationship between tobacco (smoking and non-smoking) and oral leukoplakia and oral squamous cell carcinoma (OSCC). [3] However, only a fraction of people exposed to tobacco develop oral leukoplakia and OSCC. Genetically determined differences among these individuals would explain the susceptibility. [2]

Since epidermal ridge patterns form early in fetal development and remain unchanged throughout life [3],[4] unusual dermatoglyphics may indicate gene or chromosomal abnormalities consistent with diseases such as oral leukoplakia and OSCC. This study was undertaken to study dermatoglyphic patterns in individuals with oral leukoplakia and OSCC, so that individuals with habits and similar patterns can be identified at the earliest and preventive measures can be instituted in these susceptible individuals to prevent the occurrence of oral leukoplakia and OSCC.


   Materials and Methods Top


Patients for the study were selected from regular out patient departments of Oral Medicine, Diagnosis and Radiology KLE's Institute of Dental Sciences and KLE's Medical Hospital and Research Center, Belgaum.

Study consisted of 3 groups. 30 patients were included in each group.

Group I - 30 patients with oral leukoplakia.

Group II - 30 patients with OSCC.

Group III - 30 healthy individuals with habits but no lesions as control group.

Method of collection of data:

After explaining about the study to the subjects, an informed consent was obtained. A detailed history with thorough clinical examination was done and findings were recorded in a specially prepared case history proforma. The clinically diagnosed cases of oral leukoplakia and OSCC were confirmed histopathologically and included in the study.

Materials used for obtaining palm and fingerprints:

  • Black Duplicating Ink (Kores, Bombay).
  • Good quality paper.
  • Soap, water, towel.


Procedure for obtaining prints:

To enhance the quality of dermatoglyphic prints, it is necessary to remove sweat, oil and dirt from the skin. This was accomplished by washing the ridged areas with soap and water followed by drying.

Then ink was uniformly spread over the palm and fingers. Prints of fingertip were taken first followed by that of the palm, on the paper kept over the table. Once the satisfactory prints were obtained of the fingers and palms, the patient was instructed to wash his hands with soap and water.

Then the finger and palm prints were analyzed qualitatively and quantitatively using following materials and were recorded in a specially prepared format (Annexure I):

  1. Magnifying lens.
  2. Ruler.
  3. Protractor.
  4. Pencil.
  5. Sharp/pointed instrument.


Qualitative Analysis

Fingertip patterns and palmar patterns were studied under qualitative analysis.

Fingertip patterns could be:

  1. Arches (A)
  2. Loops (L)
  3. Whorls (W)


Palmar patterns were studied as:

  1. Hypothenar area.
  2. Thenar/First interdigital area.
  3. I 2 , I 3 and I 4 interdigital area.


Quantitative Analysis [Figure 1],[Figure 2],[Figure 3],[Figure 4],[Figure 5],[Figure 6]

Quantitative analysis was done under the following headings.

  1. AB ridge count,
  2. Finger ridge count
  3. Total finger ridge count (TFRC).
  4. ATD angle.



   Results Top
[Table 1]

The above table shows distribution of various finger print patterns in patients with oral leukoplakia. Among them 06.30% have arches, 06.30% have loops and 30.70% have whorls [Table 2].

The above table shows distribution of various finger print patterns in patients with OSCC. Among them 07.00% have arches, 60.70% have loops and 32.30% have whorls [Table 3].

The above table shows distribution of various finger print patterns in control group. Among them 02.00% have arches, 30.00% have loops and 68% have whorls [Table 4],[Graph 1]-[Additional file 1].

The above table compares the frequency of various finger print patterns in all three groups. In patients with oral leukoplakia and OSCC, there is an increased frequency of arches and loops whereas in control group there is an increased frequency of whorls. P value is 0.000, which is statistically quite significant [Table 5],[Graph 2]-[Additional file 2].

The most commonly observed hypothenar pattern is arch ulnar, which is equally distributed in all the three groups and is statisttically insignificant ( P > 0.05) [Table 6],[Graph 3]-[Additional file 3].

The above table of thenar / I 1 area pattern in all three study groups in both hands presents no significant difference between the study groups ( P > 0.05) [Table 7],[Graph 4]-[Additional file 4].

The above table shows distribution of I 2 , I 3 , and I 4 area pattern in both right and left hands. There is an increased frequency of loops in controls as compared to patients with oral leukoplakia and OSCC. P value is 0.011, which is quite significant [Table 8].

The above table compares TFRC in all three study groups. It is observed that there is no significant difference in the mean TFRC between the three groups [Table 9].

The above table shows frequency of mean ab count in both hands in all three study groups. There is no significant difference in the mean ab count between the three groups [Table 10].

The above table shows frequency of mean atd angles in all three study groups of both right and left hands. No significant difference was noted ( P > 0.05).


   Discussion Top


Dr. Harold Cummins in 1936 examined several children with trisomy 21 (Down's syndrome) and found consistent dermatoglyphic changes that were absent among controls. This earth-shattering discovery helped to move the budding science of dermatoglyphics from a place of obscurity to being acceptable as a diagnostic tool among medical personnel. Since then widespread interest in epidermal ridges developed in medical field since it became apparent that many patients with chromosomal aberrations had unusual ridge formations. Inspection of skin ridges, therefore seemed promising, simple, inexpensive means for determining whether a given patient had a particular chromosomal defect. [5]

With an ever-growing population, it becomes imperative that methods be developed to identify individuals either at risk or already having a given illness in the most cost-efficient manner without sacrificing quality of care. While such an imperative is not a new concept, the use of dermatoglyphics is rather a unique approach at low cost for identifying such individuals.

In examining dermatoglyphics and cancer patients in general, one of the studies has noted an increase in whorls and a decrease in radial loops in 201 Turkish cancer patients. [6] Another study with different cancers found more whorls to be present and in studying high risk kindred also found more whorls. [7] In the other study, a decreased ridge count in patients with cancer was found. [8] Yet another study found an increased proportion of ulnar loops in cancer patients. [9]

Tobacco and alcohol are established risk factors for oral leukoplakia and OSCC, substantial evidence also suggest that the carcinogenic process is driven by the interaction between exposure to exogenous carcinogens and inherent genetic susceptibility. In response to environmental exposures, genetic damage accumulates more quickly in individuals with genetic susceptibility to DNA damage than in those without such instability but with a similar exposure. Consequently, individuals with genetic instability might be at a greater risk for developing these lesions. [2],[10]

It is suggested that many genes which take part in the control of finger and palmar dermatoglyphic development can also give indication to the development of premalignancy and malignancy, [8] hence identifying persons at high risk for oral leukoplakia and OSCC could be of great value to decrease the incidence of the same.

Considering the high mortality and high morbidity rate due to oral cancer in India, we planned to assess palmar dermatoglyphics in oral leukoplakia and OSCC and find whether a correlation exists between oral leukoplakia, OSCC and palmar dermatoglyphics.

Our study revealed differences in the dermatoglyphic patterns among various groups which could be considered genetic markers for detecting those who are predisposed to develop oral leukoplakia and OSCC. Hardly any dermatoglyphic study has been carried out in relation to oral malignancy, hence more studies with larger sample need to be undertaken to conclude the results.


   Conclusion Top


The present study on palmar dermatoglyphics in oral leukoplakia and oral squamous cell carcinoma (OSCC) has few significant parameters which would help us to identify an individual with or at risk for developing oral leukoplakia and OSCC, so that high risk individuals can be identified and preventive measures can be instituted at the earliest to prevent the occurrence of oral leukoplakia and OSCC.

This further proves that oral leukoplakia and OSCC are not just an environmentally acquired, but their roots are deep seated in the soil of genetics. Further research into the relation between oral leukoplakia, OSCC and genetics can give us more valuable clues which would probably help in preventing these diseases and free the mankind from these menacing diseases which are rampant everywhere, particularly now.

Thus, fight oral leukoplakia and OSCC with genes can be the slogan of the better today and tomorrow.

 
   References Top

1.Schaumann B, Alter M. Dermatoglyphics in medical disorders. New York: Springer Verlag; 1976.  Back to cited text no. 1    
2.Cloos J, Spitz MR, Schantz SP, Hsu TC, Zhang ZF, Tobi H, et al. Genetic susceptibility to head and neck squamous cell carcinoma. J Natl Cancer Inst 1996;88:530-5.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Galton F. Finger prints. London: McMillan; 1982.  Back to cited text no. 3    
4.Henry ER. Classification and uses of finger prints. 8 th ed. London: H. M. Stationary Office; 1937.  Back to cited text no. 4    
5.Whitelaw WA. The proceedings of the 11 th annual history of medicine days. Available from: http://www.hom.ucalgary.ca/dayspapers2002.pdf. [cited in 2002].  Back to cited text no. 5    
6.Atasu M, Telatar H. Cancer and dermatoglyphics. Lancet 1968;20:861.  Back to cited text no. 6    
7.Lynch HT, Kaplan AR, Moorhouse A, Krush AJ, Clifford G. Dermatoglyphic peculiarities in members of a high-cancer-risk kindred. Prog Exp Tumor Res 1974;19:325-32.  Back to cited text no. 7    
8.Fuller IC. Inherited predisposition to cancer: A dermatoglyphic study. Br J Cancer 1973;28:186-9.   Back to cited text no. 8    
9.Chorlton SH. Dermatoglyphics, blood-groups and cancer. Lancet 1970;21:627.   Back to cited text no. 9    
10.Wu X, Lippman SM, Lee J, Zhu Y, Wei QV, Thomas M, et al. Chromosome instability in lymphocytes: A potential indicator of predisposition to oral premalignant lesions. Cancer Res 2002;62:2813-8.  Back to cited text no. 10    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9], [Table 10]



 

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