|Year : 1995 | Volume
| Issue : 1 | Page : 11-15
A study of palmar dermatoglyphics and palmar freckles
Source of Support: None, Conflict of Interest: None
A study of palmar dermatoglyphics in genodermatoses was conducted in 219 probands and 100 control subjects by standard ink and roller method, during the period 1977-81 at Government General Hospital, Madras. A study of palmar dermatoglyphics in 20 probands with definite clinical and histopathological evidence of Neurofibromatosis revealed an increased incidence of ulnar loop pattern over the finger tips in both sexes. This digital pattern was not found to be of statistical significance, but a statistically significant reduction in the mean a-b ridge count was observed in female cases. An increased incidence of palmar freckles (60%) was observed as a serendipity while taking the palm prints. Some of the palmar freckles with tiny palpable underlying nodules on histopathological study revealed miniature neurofibroma in the dermis. This serendipity has been recorded as an important clinical sign of neurofibromatosis by the author in her thesis submitted for Doctorate degree in 1981.
Keywords: Palmar Dermatoglyphics, Neurofibromatosis, Palmar freckles
|How to cite this article:|
Premalatha S. A study of palmar dermatoglyphics and palmar freckles. Indian J Dermatol Venereol Leprol 1995;61:11-5
|How to cite this URL:|
Premalatha S. A study of palmar dermatoglyphics and palmar freckles. Indian J Dermatol Venereol Leprol [serial online] 1995 [cited 2019 Nov 22];61:11-5. Available from: http://www.ijdvl.com/text.asp?1995/61/1/11/4116
| Introduction|| |
A dermatoglyph is a natural "carving" in the skin that is a furrow or fold. The development of a dermatoglyphic pattern in the intrauterine life is strongly influenced by genetic factors. A study of palmar dermatoglyphic pattern in genodermatoses has been undertaken to find out whether a specific dermatoglyphic pattern is present in a particular genodermatosis. Neurofibromatosis is a neurocutaneous abnormality determined by a dominant gene. It may also occur due to mutation. Hence cases of neurofibromatosis have been included in this study. Palmar freckles in the cases of neurofibromatosis have been noticed as a serendipity during the present study.
| Materials and Methods|| |
Twenty probands with definite clinical and histopathological evidence of neurofibromatosis were studied during the years 1977-81. They attended the skin department of Government General Hospital, Madras for cosmetic significance. A family pedigree was drawn for all cases. A study of palmar dermatoglyphics was done in the probands and their affected family members. One hundred phenotypically normal individuals (50 males and 50 females), who were not related to each other, were studied as control subjects. Both the probands and the controls studied were south Indians. Rolled impressions of the fingers and plain impressions of the palm were obtained on smooth white papers by the standard ink and roller method. The palm and finger prints were studied for the parameters of both qualitative and quantitative analysis. The findings were analyzed, tabulated and their statistical significance was noted.
| Results|| |
Twenty cases of neurofibromatosis (15 females and 5 males) were studied. The minimum age recorded was 5 years and the maximum age was 55 years. Family members were affected in 4 cases. All cases were presented with typical nodular lesions of neurofibromatosis except case No. 14 which showed only cafe-au-lait spots. Strangely depigmentation was present over the nodular lesions of the back in one of the cases. Histopathological study of the depigmented nodule revealed absence of pigment in the basal cell layer of the epidermis overlying the tumour mass of neurofibroma. Histopathological study of one of the nodular lesions in other cases showed typical features of neurofibroma. All cases had cafe-au-lait spots. Seven cases (35%) had axillary freckless. Twelve cases (60%) showed palmar freckles. Seven cases (35%) showed freckles over the soles in addition to palmar freckles. Some of the palmar freckles had even palpable nodular lesions of neurofibroma underneath and revealed as "smudges" in the plain impressions of the palms [Figure - 1]. Histopathological study of these freckles showed tiny bit of neurofibromatous tissue in the dermis. As the incidence of palmar freckles was greater than that of the axillary freckles (Crowe's Sign) presence of palmar freckles could be considered as an important clinical sign of neurofibromatosis. Hard of hearing was present in case No. 4. Kyphosis was present in case No. 9. Naevus spilus was present in case No. 20. The clinical findings of these 20 cases of neurofibromatosis are summarized in [Table - 1].
| Dermatoglyphic Study :|| |
| Qualitative Analysis :|| |
The finger tip patterns observed were ulnar loop, whorl, radial loop and arch. Ulnar loop was the domination pattern in both sexes. The incidence of ulnar loop pattern (68%) was equal in both hands in males, whereas the incidence was higher in the right hand than that of the left hand in females. The incidence of whorl pattern in the right hand (28%) was higher than that of the left hand (16%) in males. But females showed a slightly higher incidence of whorl pattern in the left hand (32%) than that of the right hand (30.7%). Radial loop pattern was more in the left hand (12%) than that of the right hand (4%). The occurrence of radial loop pattern was very much less when compared with that of males. The incidence of radial loop in the left hand in the female was 1.3% and radial loop pattern was absent over the finger tips of the right hand in females. Arch pattern was absent over the finger tips of the right hand in males. The incidence of arch pattern in the left hand of males and the right hand of females were equal (4%). A little higher incidence was noted in the left hand of the females (5.3%).
All palmar areas showed patterns. The incidence of Th/I1 area patterns were equal in both hands in both sexes. It was 40% in both palms in males and 13.3% in both palms in females. Carpal loop (Lc) and ulnar loop (Lu) patterns were observed. Only one male case showed small loop pattern (1) in I2 area of right palm. Two female cases showed small loop pattern in I2 area, one case in the right palm and the other in the left palm. The patterns observed in I3 area were small loop (1) long loop (L). The incidence of I2 area pattern was equal in both palms in males (60%) but it was higher in the right palm (46.7%) than that of the left palm (26.7%) in females. Patterns observed in I4 areas were small loop (1) and large loop (L). The incidence of I4 area pattern was equal in both palms in males (40%). It was slightly higher in the left palm (60%) than that of the right palm (46.7%) in females. Hypothenar patterns were absent in the right palm of males. Two male cases showed pattern in the left hypothenar area (40%). They were ulnar loop (Lu) and radial loop (Lr) patterns. Four female cases showed patterns (Lu and Lr) in the hypothenar area. The incidence was higher in the right palm (20%) than that of the left palm (6.7%). White lines were observed in 1 male case and white dots were observed in 1 female case. The findings are summarized in [Table - 2].
| Quantitative Analysis :|| |
The mean TFRC was 146 in males and 128.8 in females. The mean a-b ridge count was 35.8 in males and 35.1 in females. The mean atd angle was 43.1% in males and 43.5% in females. Position of axial triradius was t,t' and t". Position of axial triradius t was 45%, t' was 40% and t" was 15% in both hands. The results are summarized in [Table - 3].
| Discussion|| |
An increased frequency of digital whorls was reported in neurofibromatosis in literature. An increased incidence of central pocket whorls on the 4th & 5th digit has been reported in neurofibromatosis in literature. The present study has revealed an increased incidence of ulnar loops over the finger tips in both sexes and an increased incidence of whorls was observed in the fourth digit of the right hand. Two cases of neurofibromatosis studied by Saha also showed predominance of loop patterns.
A reduction was observed in mean a-b ridge count in female cases of neurofibronmatosis in the present study. This finding was statistically significant when compared with the controls.
As the incidence of palmar freckles (60%) is greater than that of the plantar freckles (35%) and axillary freckles (35%), the presence of palmar freckles in neurofibromatoses has been recorded by the author as an important clinical sign of neurofibromatosis in the research thesis submitted for her Ph.D degree in 1981. The author has pointed out this sign to her senior colleague Patrick Yesudian. Fifty cases have been studied in detail and recorded in the world literature in 1984. Recently, the author has observed melanotic macules even in the oral and palpebral conjunctival mucosa of 2 cases of neurofibromatosis. Further study can confirm their significance. The author would like to conclude that the increased incidence of palmar freckles has been noticed as a serendipity and recorded as an important clinical sign in neurofibromatosis earlier in her thesis in 1981. The same finding has been studied in detail by Patrick Yesudina et al later and recorded in the literature in 1984.[6 ]Recently a further study was conducted on the same topic and the findings were presented as a new sign in neurofibromatosis at the International Congress of Dermatology, New Delhi, 1994, which has confirmed the significance of this clinical sign.
| References|| |
|1.||Gibbs RC, Fundamentals of Dermatoglyphics. Arch Dermatol 1967;721-5. |
|2.||Polani PE, Polani N, Chromosomal anomalies, mosaicaism and dermatoglyphic asymmetry. Ann Hum Genet 1969;32:391-402. |
|3.||Shino H, Kadowaki J. Dermatologic uses of dermatoglyphics. Int J Dermatol 1978;17:134-7. |
|4.||Saha KC. Preliminary observations on dermatoglyphics in Genodermatosis. Ind J Dermatol Venereol Leprol 1969;14:118-20. [PUBMED] |
|5.||Premalatha S. Neurofibromatosis In : Palmar dermatoglyphics in genodermatoses studied in a skin clinic - Thesis submitted for Ph.D Degree, University of Madras 1981,159-62. |
|6.||Yesudian P, Premalatha S, Thambiah AS. Palmar melanotic macules - A sign of neurofibramatosis. Int J Dermatol 1984;23:468-71. [PUBMED] |
|7.||Jayaraman M, Rajagopal S, Janaki VR, et al. Neurofibramatosis - A new sign - a new histological observation and a few unusual manifestation - a study of 66 cases. In : Book of Abstracts, VII International Congress of Dermatology, New Delhi 1994,76. |
[Figure - 1]
[Table - 1], [Table - 2], [Table - 3]