|Year : 2017 | Volume
| Issue : 3 | Page : 191-194
Dermatoglyphics in patients with oral potentially malignant diseases and oral cancer
Prashant B Patil, Jyothsna Jayaram Reddy, Vajendra Joshi, Kotagudda Ramaiah Kiran Kumar, Ravishankar Thayi Shilpa, Pathalapati Satyanarayana
Department of Oral Medicine and Radiology, Navodaya Dental College and Hospital, Raichur, Karnataka, India
|Date of Submission||10-Feb-2017|
|Date of Acceptance||07-Nov-2017|
|Date of Web Publication||20-Nov-2017|
Jyothsna Jayaram Reddy
Department of Oral Medicine and Radiology, Navodaya Dental College and Hospital, Raichur, Karnataka
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Aim: To study and compare the dermatoglyphic and palmar prints of subjects without tobacco chewing/smoking habit, with tobacco chewing/smoking habits without lesions, with potentially malignant diseases, and with oral cancer. Material and Methods: A comparative preliminary study was conducted in 60 subjects who visited Department of Oral Medicine and Radiology, Navodaya Dental College and Hospital, Raichur, Karnataka, India. The subjects were divided into four groups; 15 healthy controls (Group A), 15 subjects with tobacco habits and without associated lesions (Group B), 15 subjects with potentially malignant diseases (Group C), and 15 subjects with oral cancer (Group D). Dermatoglyphic and palmar prints were obtained by standard India ink method. Prints were analyzed by single observer twice at an interval of 15 days. The data obtained was subjected to statistical test using SPSS software 19 version. Chi-square test was applied to compare the different patterns among groups, and weighted kappa test for intraobserver variability. Results: Among dermatoglyphic patterns, whorl pattern was increased by 60.66% in Group C and 46% in Group D. Oral cancer subjects showed significant decrease in mean accessory tri-radii digital angle (37.13°). Conclusion: Dermatoglyphics can aid as a screening tool for early detection of high-risk individuals with potentially malignant disorders and oral cancer.
Keywords: Accessory triradii, dermatoglyphics, oral cancer, potentially malignant diseases, tobacco habit
|How to cite this article:|
Patil PB, Reddy JJ, Joshi V, Kumar KR, Shilpa RT, Satyanarayana P. Dermatoglyphics in patients with oral potentially malignant diseases and oral cancer. J Indian Acad Oral Med Radiol 2017;29:191-4
|How to cite this URL:|
Patil PB, Reddy JJ, Joshi V, Kumar KR, Shilpa RT, Satyanarayana P. Dermatoglyphics in patients with oral potentially malignant diseases and oral cancer. J Indian Acad Oral Med Radiol [serial online] 2017 [cited 2020 Oct 29];29:191-4. Available from: https://www.jiaomr.in/text.asp?2017/29/3/191/218717
| Introduction|| |
Dermatoglyphics deals with study of the epidermal ridges and their configurations on the finger tips, palms, and soles. It has been a useful tool in understanding the basic questions in biology, medicine, genetics, and evolution and is becoming the most widely used method for personal identification. Harold Cummins and Mildo in 1926 coined the term “Dermatoglyphics” (derived from Greek word - Derma = skin, Glyphe = carving). The dermatoglyphic and palmar prints are formed during the 6th–7th week of the embryonic period and are completed after 10th–20th weeks of gestation., These dermatoglyphic patterns are genetically determined and remain unchanged from womb to tomb and persists lifelong until and unless there is any damage to dermis., In current scenario, dermatoglyphics is widely used in the dentistry to detect the genetic basis of various conditions like cleft lip and palate, early childhood caries, developing malocclusion in pediatric population, periodontal diseases, bruxism, and also potentially malignant and malignant conditions. Several researches have proven that genetic and environmental factors are important determinants in causation of oral potentially malignant diseases (PMDs) and oral cancer., In this context, dermatoglyphics can be a valuable adjunct tool to other diagnostic methods in identifying various diseases of genetic origin.,
The present study was conducted to study the role of dermatoglyphics in the early detection of individuals who are at risk of developing PMDs and oral cancer.
| Materials and Methods|| |
Patients visiting outpatient department of Oral Medicine and Radiology, Navodaya Dental College and Hospital, Raichur, Karnataka were selected by systemic random sampling method. Institution ethical committee approval and informed consent was obtained prior to conduct of the study. The study was carried out from January 2015 to August 2015, with a total number of 60 subjects who were selected on a calendar method or periodic basis visiting in that span and were divided into four groups:
- Group A: 15 healthy subjects
- Group B: 15 subjects with habits and no associated lesions
- Group C: 15 subjects with PMDs
- Group D: 15 subjects with oral cancer (histopathologically confirmed).
Subjects who had oral lesions due to causes like sharp tooth margins/improper restorations/prosthesis, presence of any scars or any injury over the finger tips and palm and subjects with any underlying systemic diseases were excluded from the study.
Armamentarium included Kores duplicating ink, cotton applicator, thick executive bond, magnifying lens, conventional ruler, conventional protractor, red color pencil [Figure 1]. A structured case history format was designed and detailed history was recorded. Thorough clinical examination of the oral cavity was done using mouth mirror and probe under illuminating light with normal patient position. If any mucosal lesion was present, it was recorded in detail according to WHO criteria 1980.
All the subjects who were included in the study group were first asked to wash their hands with handwash. The finger prints were obtained by Standard ink method. Duplicating ink was applied on the palmar surface with cotton applicator uniformly and subjects were asked to press their palm on white executive bond sheet and pressure was applied from examiners hand for better clarity. The thumb print was separately obtained on one corner of the paper. [Figure 2]a,[Figure 2]b,[Figure 2]c,[Figure 2]d.
|Figure 2: (a-d) Recording finger and palm pattern using Kores duplicating ink|
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Analysis of dermatoglyphic pattern/finger tip pattern of each finger tip on right and left hand was done and the frequency of each pattern was recorded [Figure 3]a,[Figure 3]b,[Figure 3]c., The total number of finger prints obtained in each subject were 10. All the observations were evaluated by single observer and reanalyzed after 15 days.
On the palmar surface certain triradius points can be appreciated, these are formed by confluence of three ridge systems forming an angle of 120° with one another. These are named as accessory triradii (ATD) 'A', 'B', 'C' and 'D,' which is present at the distal portion of index, middle, ring and little finger, respectively. The triradius found in the hypothenar area is 'T'. The angle formed by joining tri-radius 'A' to the axial tri-radius 'T' and from 'T' to digital tri-radius 'D' is known as ATD angle and is measured with the help of analogue protractor [Figure 4].
| Results|| |
In the present study, the subjects were in the age group range between 22 and 70 years and among 60 subjects 16 were females and 44 were males. The total finger print pattern obtained were 150 in each group. There are various finger print patterns like arches, loops (including ulnar and radial loops) and whorl patterns. In subjects with oral cancer and PMDs (study groups C and D), the whorl pattern was increased in frequency (60.66% and 46%, respectively) followed by arch pattern (24.66% and 19.33%, respectively) when compared to Groups C and D, the subjects of Group B who were having the history of gutkha/arecanut chewing or smoking showed increased ulnar loops (46.66%) followed by whorl pattern (36.66%), where as in healthy individuals (control group) there was increased frequency of ulnar loops (53.33%) [Table 1]. When comparison of the finger patterns among all the four groups was done, it was statistically significant with a 'P' value of <0.05. Whorl pattern was significantly increased from Group A to D (A = 33.34%, B = 36.66%, C = 46%, and D = 60.66%); Arch pattern was also significantly increased from Group A to D (A = 12%, B = 16.66%, C = 19.33%, and D = 24.66%), whereas the ulnar loop pattern was decreased from Group A to D (A = 53.33%, B = 46.66%, C = 34.66%, and D = 13.33%) [Figure 5].
The right ATD angle was significantly decreased from Group A to D (A = 41.20°, B = 39.53° and D = 37.13°), except Group C (40.53°), the left ATD angle also was significantly decreased from A = 42.53°, B = 40.47° and D = 37.13° except Group C (41.67°) [Table. 2]. Mean ATD angle showed significant reduction (37.13°) in group D or subjects with oral cancer, where as in other groups the mean ATD angle was 41.87° (Group A), 40° (Group B), 41.10° (Group C), respectively [Figure 6]. When the mean ATD angle was taken into consideration from all the groups, only patients with oral cancer showed significant reduction. Comparison of the left, right, and mean ATD angle showed statistically significant difference (P< 0.05) when comparison was done between the groups [Table 2]. The intra-observer reliability was almost perfect agreement based on weighted kappa (k) statistics, where the value was K = 1.000.
| Discussion|| |
Dermatoglyphic patterns are the individuals ridge configurations on the fingers and sole which are unique and remain unchanged lifetime, until and unless there is fluctuating asymmetry in the form of genetic and environmental stress., To assess this fluctuating asymmetry the present study was conducted and dermatoglyphic patterns and palmar patterns were analyzed. The present study included 60 subjects, divided into four groups.
It was observed that whorl patterns followed by arch pattern were increased among subjects with PMDs and oral cancer (Group C and D) subjects. Similar to our study, Satish Kumar et al. also reported increased whorl patterns among PMDs when compared to healthy subjects. In the year 2006, Sakineshi Abbas et al., observed increased whorl pattern among breast cancer women and he concluded that subjects with more than six whorl pattern were very much under risk for developing malignancy. Various authors,,,,,, have reported increased arch pattern among oral submucous fibrosis and oral cancer subjects. Arch pattern was the second most common pattern observed among the subjects in the study, this could be due to the fluctuating asymmetry among the subjects and ethnic variation when compared to previous studies.
The palmar patterns were analyzed by measuring ATD on right and left hand prints. Oral cancer subjects showed marked decrease in mean ATD (37.13°). Gupta et al., study in the year 2013, found that right ATD angle was decreased in oral cancer subjects as compared to other groups. Additionally, in the present study, it was observed that the ATD angle was decreased in both the hands. Ulnar loop pattern was observed with increased frequency among healthy controls (Group A) and subjects with tobacco chewing habit without any lesions (Group B). This finding was consistent with Maria Priscilla David et al., study where they showed that loop patterns were increased among healthy controls.
The present study proves that variations in dermatoglyphic and palmar patterns could be considered as genetic markers for detecting those individuals who are at high risk for developing these diseases. Increase in whorl and arch pattern in the present study can be considered as dermatoglyphic markers; additionally, mean ATD angle was found to be decreased among oral cancer subjects. There are very few studies that have been done on ATD angle analysis. The present study shows that dermatoglyphics can be efficiently employed as a screening tool to identify the individuals at high risk of developing oral PMDs and oral cancer. Using this, they can be counseled and motivated to change their lifestyle, and reduce the morbidity and mortality associated with it. The results of the present study should be interpreted with caution since it has been carried out on a limited and selective sample representing both urban and rural areas. Hence, future studies on a larger sample with age, sex, and race matched would further help to extrapolate the results of the present study.
| Conclusion|| |
Thus, dermatoglyphics has shown promising results in determining the individuals with genetic susceptibility to develop oral PMDs, and oral cancer. It serves as an adjunct diagnostic modality, which can be used in dental clinics on a routine basis as to identify the population who are at an increased risk.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
[Table 1], [Table 2]