|Year : 2017 | Volume
| Issue : 1 | Page : 1-5
Dermatoglyphics: Revival in oral pre-cancers and cancers, a review
N Lakshmana1, Abhishek Singh Nayyar2, A Ravikiran3, Y Samatha3, Vamsi B Pavani1, B Kartheeki2
1 Department of Oral Medicine and Radiology, Sri Sai Dental College and Hospital, Srikakulam, India
2 Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
3 Department of Oral Medicine and Radiology, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
|Date of Web Publication||19-Dec-2016|
Abhishek Singh Nayyar
44, Behind Singla Nursing Home, New Friends' Colony, Model Town, Panipat - 132 103, Haryana
Source of Support: None, Conflict of Interest: None
Dermatoglyphics deals with the study of the epidermal ridges and their configurations on the fingers, palms, and soles. The word dermatoglyphics is derived from the Greek word derma meaning skin and glyphics meaning carvings. Dermatoglyphics, once matured, remain unchanged throughout the life of an individual and are not influenced by either the environmental or age-related factors. Because of these unique characteristics, these dermal ridges play a very crucial role in the personal identification of an individual, for forensic purposes. Dermatoglyphics has also been accepted as a simple and inexpensive means for deciding whether a patient would have a particular genetic or chromosomal disorder or not. The question, now, is to test the predictive possibilities of dermatoglyphics in search of the various oral precancers and cancers as the studies conducted so far have been convincing. The present review focuses on this aspect of dermatoglyphics.
Keywords: Dermatoglyphics, epidermal ridge configurations, oral precancers and cancers
|How to cite this article:|
Lakshmana N, Nayyar AS, Ravikiran A, Samatha Y, Pavani VB, Kartheeki B. Dermatoglyphics: Revival in oral pre-cancers and cancers, a review. CHRISMED J Health Res 2017;4:1-5
|How to cite this URL:|
Lakshmana N, Nayyar AS, Ravikiran A, Samatha Y, Pavani VB, Kartheeki B. Dermatoglyphics: Revival in oral pre-cancers and cancers, a review. CHRISMED J Health Res [serial online] 2017 [cited 2021 Apr 12];4:1-5. Available from: https://www.cjhr.org/text.asp?2017/4/1/1/196032
| Introduction|| |
Dermatoglyphics deals with the study of the epidermal ridges and their configurations on the fingers, palms, and soles.  The word dermatoglyphics is derived from the Greek word derma meaning skin and glyphics meaning carvings.  Cummins and Midlo (1926) coined the term dermatoglyphics (derma = skin; glyphics = carvings) for the scientific study of ridges as well as the ridges themselves. , Unusual ridge configurations have been shown to exist not only in the individuals affected with chromosomal defects but also in the ones with single gene disorders and in some in whom the genetic basis of the disorder is still unclear.  The development of dermatoglyphic patterns begins with the appearance of fetal pads in the 6 th week of gestation and reaches maximum size between the 12 th and 13 th weeks becoming full-grown in the 24 th week of gestation.  From this stage onward, they are unaffected by the extraneous factors and this explains their unique role as an ideal marker for individual identification and the study of populations, as well as detection of defects due to intrauterine irregularities in the early stages of pregnancy. Although dermatoglyphics are assumed to have a genetic basis for their development, the exact mechanism of inheritance is still unknown. Carter and Matsunaga have postulated that abnormalities in dermal ridges can only appear when a combination of hereditary and environmental factors exceed a certain level.  Such factors lead to changes in the local environment including an inadequate blood/oxygen supply, unusual distribution of sweat glands, and alterations in the epithelial growth patterns although bruises and cuts could also influence the ridge patterns.  These finger and palmar prints are permanent variables and inherited, differ among parents and their children, siblings, and even in monozygotic, identical twins. Because of these unique characteristics, these dermal ridges play a very crucial role in the personal identification of an individual, for forensic purposes.  Dermatoglyphics has also been accepted as a simple and inexpensive means in the diagnosis of numerous disorders of genetic and nongenetic origin. Since the discovery of dermatoglyphics in 1926, it has been used in the study of several genetic abnormalities.  The dermatoglyphic patterns of children with Down's syndrome were studied by Cummins in 1936.  He elucidated consistent dermatoglyphic changes in these children as compared to the controls. This breakthrough innovation advanced this art of dermatoglyphics to its being used as a marker in prediction of numerous disorders. Since most of the investigations required to confirm the diagnosis in hereditary disorders are complex and expensive, dermatoglyphics can be efficiently employed with other clinical signs as a screening procedure as a noninvasive, simple, and inexpensive procedure. The question, now, is to test the predictive possibilities of dermatoglyphics in search of the various oral precancers and cancers as the studies conducted so far have been convincing. The present review focuses on this aspect of dermatoglyphics.
| Common oral precancerous lesions and frank oral cancers|| |
Leukoplakia is considered as one of the most common premalignant lesions in the category of potentially malignant epithelial lesions (PMELs) (van der Waal 1997), most commonly encountered in the oral cavity (leuko means white; plakia means patch). , The World Health Organization (WHO) defined oral leukoplakia (OL) as a white lesion that cannot be characterized as being a result of any other specific disease of the oral mucosa.  OL is considered to be one of the common PMELs of the oral mucosa with a malignant transformation rate in various studies and locations ranging from 0.6% to 20%.  An annual malignant transformation rate of 0.3% has been reported. In studies from Western countries, somewhat higher figures have been mentioned with an annual malignant transformation rate of approximately 1%, probably a reasonable average figure for all types of leukoplakia together.  Oral submucous fibrosis (OSF), on the other hand, is another common premalignant condition associated mainly with the chewing of areca nut, an ingredient of betel quid, and is more prevalent in the South Asian populations.  OSF is also called as diffuse OSF, idiopathic scleroderma of mouth, idiopathic palatal fibrosis, sclerosing stomatitis, juxta-epithelial fibrosis, etc.  It is a potentially malignant disorder and a crippling condition of the oral mucosa.  Although available epidemiological evidences suggest that chewing of gutkha is an important risk factor for the development of OSF, genetic etiology of OSF had been studied since 1986 suggesting a genetic predisposition.  The occurrence of OSF is more or less restricted to Southeast Asia although a number of cases have also been reported in other parts of the world where such an etiology is not seen suggesting a possible role of genetic factors toward the same.  Furthermore, although, most of the available epidemiological evidence indicates that the chewing of gutkha and use of tobacco (smoking and nonsmoking) are an important risk factor for OSF, not all individuals develop the same. Patients without any risk factors also develop a malignancy explaining the role of genetic factors as a plausible explanation for such an individual variation. , Through an, as yet, unknown phenomenon in the later stages of the disease process, fibrosis and hyalinization occur in the lamina propria in the affected patients which results in the atrophy of the overlying epithelium. This atrophic epithelium apparently predisposes toward the development of frank malignant transformation in the presence of carcinogens. In a long-term follow-up study, the annual malignant transformation rate for OSF was found to be approximately 0.5%.  Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity arising from the stratified squamous epithelium of the oral mucosa, corresponding to around 95% of the malignant lesions seen. Worldwide, OSCC is the sixth common cancer, and in the Indian subcontinent, OSCC is a major health problem.  OSCC holds eighth position in the cancer incidence ranking worldwide with the epidemiologic variations between different geographic regions. It is the third most common malignancy in South-central Asia.  The WHO expects a worldwide increase in the reported cases of OSCC incidence in the next one or two decades. In the US, OSCC represents 2%-4% of the annually diagnosed malignancies, being responsible for 8000 deaths every year. , In the US, at the time of diagnosis, 36% of the patients have localized disease, 43% regionally spread disease, whereas 9% of the patients present with distant metastasis at the time they first report for diagnosis.  The average incidence of OSCC is half a million new cases around the world which can present an important health problem, especially in some geographical locations.  Regarding the etiopathogenesis of OSCCs, it is believed that some patients appear susceptible to cancers because of an inherited trait which affects their ability or inability to metabolize carcinogens and/or procarcinogens. Others have an inherited impaired ability to repair the damaged DNA which follows after exposure to the carcinogens. In some others, the susceptibility to cancers may be acquired as in some acquired immune defects. In a few, there are inherited susceptibilities arising from disordered function of the genes controlling the fate of chromosomally damaged cells and the cell cycle-tumor suppressor genes and genes involved in cell signaling (proto-oncogenes and oncogenes).  One of the studies has evaluated genetic polymorphism in drug metabolizing enzymes related to CYP1A1, GSTMI, and GSTT1 genes, and oral cancer susceptibility in a case-control study and reported that habitual betel quid/tobacco chewers of Indian ethnicity who are carriers of the GSTMI and GSTT1 null genotypes are at an exceptionally increased risk for developing OL, a precancerous lesion, frequently turning into frank malignancy. Based on these data, they also concluded that identification of such cancer-prone individuals by GSTM1/GSTT1 genotyping and subsequent, preventive measures would appear feasible to control mortality at a larger scale. 
| Discussion|| |
It was in 1926 that Cummins introduced the term dermatolgyphics. , According to Pour-Jafari, dermatoglyphics is the study of the patterns of the ridged skin of palms and soles.  It was first used in India for personal identification by Herschel. , The pattern remains unchanged throughout life except for an increase in size with general growth.  Fingerprints are a multifactorial trait. A large number of genes interplay with environmental influences in forming these distinct fingerprints.  Sir Galton conducted an extensive research on the significance of skin ridge patterns not only to demonstrate their permanence but also their use as a means of personal identification. He demonstrated the hereditary significance of fingerprints and the biological variations of different fingerprint patterns among the different racial groups. , Ramani P et al. (1982) observed the genetic component for various fingertip patterns.  Once formed, they are age and environment stable, becoming a reliable indicator, of a genetic damage.  At present, researchers claim the study of dermatoglyphics is an important diagnostic tool for some diseases, especially the ones with obscure etiology and mysterious pathogenesis. Diagnosis of a plethora of diseases which is genetically or nongenetically determined can, now, be aided by dermatoglyphic analysis. 
| Dermatoglyphic studies in oral precancers and cancers|| |
Epidemiological and experimental evidence indicates a causal relationship between tobacco (smoking and nonsmoking) and the development of various oral precancers and frank cancers; however, only a fraction of people exposed to tobacco develop such lesions as well as frank OSCC. OL and OSF are the prime lesions to be considered in this regard as most of the OSCCs are preceded by either of these two precancerous lesions and/or conditions.  Genetically determined differences among individuals explain the susceptibility.  Furthermore, there has been a relative dearth of research into this area, wherein dermatoglyphics have been used in the prediction of an individual toward the development of such lesions as well as frank OSCCs. 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.  Another study with different cancers also found more whorls to be present.  In another study, a decreased ridge count in patients with cancer was found.  Yet, another study found an increased proportion of ulnar loops in cancer patients.  Tobacco and alcohol are established risk factors for OL and OSCC. Substantial evidence also suggests that the carcinogenic process is driven by the interaction between exposure to exogenous carcinogens and an 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. , Very few studies, till date, actually have been carried out to assess dermatoglyphic patterns in cancer patients. Venkatesh et al., performed a study on palmar dermatoglyphics in patients with OL and OSCC. Their results showed a significant increase in the frequency of arches in patients with OL and OSCC.  A study conducted by Gupta et al. also showed promising results by observing an increased frequency of arches and ulnar loop patterns on fingertips with a decreased frequency of simple whorl patterns on fingertips and a decreased frequency of palmar accessory triradii on the right and left hands in OSCC patients. Significant findings in OSF patients included an increase in the frequency of arches and ulnar loop pattern, decrease in the frequency of simple whorl patterns on fingertips, decrease in ATD angle on the right hand, and a decrease in the frequency of palmar accessory triradii on the right hand.  A study by Tamgire et al. showed a highly significant decrease in simple whorl pattern on the left little finger in OSF patients.  In oral cancers, dermatoglyphic patterns, grossly, have shown an increased frequency of arch pattern on the fingertips.  The study conducted by Venkatesh et al. showed 70% whorls and 6.30% loop type of fingerprints in leukoplakia and OSCC patients, respectively. In another study on OSCC patients, 70% loops, 32.30% whorls, and 7.0% arch pattern of fingerprints were found.  The study conducted by Gupta et al. reported an increased percentage of loops in the OSF group.  Tamgire et al., however, reported that there was no statistically significant difference in the different patterns among the gutkha chewers with and without OSF, and that on digit-wise comparison, there was a significant increase of whorl pattern in the right and left thumbs of gutkha chewers with OSF.  The study conducted by Ganvir and Gajbhiye found that whorl type of fingerprint pattern was predominant in significantly higher number of individuals of OSCC and OSF groups than in the control groups, wherein individuals of the control group showed loop as the predominant fingerprint pattern.  Furthermore, the study conducted by Kumar et al. showed that there was a significant decrease of tented arches and ulnar and radial loops and an increase of simple whorls in OSF patients as against the controls.  To conclude, the variations seen in studies conducted, so far, contradicting the role of dermatoglyphics, might be reasoned out due to geographic variations. Segura-Wang and Barrantes also reported that there is a significant interpopulation variation in dermatoglyphic patterns which should be kept in mind before coming to a definite conclusion. 
| Conclusion|| |
The study of dermatoglyphics dates back to 1792-1750 B.C. although the exact use of the same as far as their role in the diagnosis of various disorders is concerned has still to be searched. The role of dermatoglyphics is established for forensic purposes as well as numerous medical disorders with obscure etiology; however, their role as a diagnostic tool in various oral precancers and cancers still remains debatable with want of further research although fewer studies conducted in this regard have given initial convincing results. The relevance of dermatoglyphics is not for diagnosis, but for prevention, by predicting a disease, and not for defining an existing disease, it is for identification of people with a genetic predisposition to develop the disease.
To all the patients who contributed in the study without whom this study would not have been feasible.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
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