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ORIGINAL ARTICLE
Year : 2016  |  Volume : 14  |  Issue : 1  |  Page : 41-45

Dermatoglyphics as a genetic marker for oral submucous fibrosis: A cross-sectional study


Department of Public Health Dentistry, Krishnadevaraya College of Dental Sciences, Bengaluru, Karnataka, India

Date of Web Publication15-Mar-2016

Correspondence Address:
Punith Shetty
Department of Public Health Dentistry, Krishnadevaraya College of Dental Sciences, International Airport Road, Hunsamaranhalli, Bengaluru - 562 157, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-5932.178730

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  Abstract 

Introduction: Genetics play an important role in the determination of palmer dermatoglyphics. Oral submucous fibrosis (OSMF) in India is high due to excess consumption of areca nut. Hereditary and environmental factors causing OSMF may lead to peculiarities in the dermatoglyphic patterns. Dermatoglyphics can identify the disease at the earliest, and preventive measures can be instituted for subjects having OSMF. Aims: To assess the dermatoglyphic pattern of subjects with OSMF and to compare it with that of the control group. Materials and Methods: This cross-sectional study was conducted among patients 15 years and older visiting the Outpatient Department of a dental institute. They were selected based on predefined inclusion and exclusion criteria. The sample size was determined using G*Power software. The sample size thus determined was 39 which was rounded off to 40, thus 20 subjects were allotted to each group. The dermatoglyphic pattern of both hands of the study and control group was obtained using a special standard ink method. The dermatoglyphic patterns were analyzed qualitatively for loops, arches and whorls. Chi-square test was used to determine the difference in dermatoglyphic patterns of the two groups. Results: The percentage of whorls in study groups was 24% and 20% in the right and left hand respectively, as compared to 7% and 5% in controls group. The percentage of arches in study group was 0% and 1% in the right and left hand respectively as compared to 8% and 7% in control group. These differences were found to be statistically significant (P < 0.05). Conclusions: Difference between the percentage of arches and whorls of the two groups was found to be significant suggesting that dermatoglyphics could be used as a genetic marker for determining susceptibility toward OSMF.

Keywords: Dermatoglyphics, genetic markers, oral submucous fibrosis


How to cite this article:
Shetty P, Shamala A, Murali R, Yalamalli M, Kumar A V. Dermatoglyphics as a genetic marker for oral submucous fibrosis: A cross-sectional study. J Indian Assoc Public Health Dent 2016;14:41-5

How to cite this URL:
Shetty P, Shamala A, Murali R, Yalamalli M, Kumar A V. Dermatoglyphics as a genetic marker for oral submucous fibrosis: A cross-sectional study. J Indian Assoc Public Health Dent [serial online] 2016 [cited 2019 Apr 18];14:41-5. Available from: http://www.jiaphd.org/text.asp?2016/14/1/41/178730


  Introduction Top


One of the key factors in the prevention of disease is to identify risk factors early in life so that tailor-made preventive measures can be implemented depending on the degree of risk for each individual. The medical community has been tirelessly working towards the identification of new risk factors and researching cost effective methods to diagnose them. Based on the fact that a number of oral diseases are genetically determined especially cancers and precancerous lesions, certain genetic markers may prove to be risk factors and their determination may help predict and thereby preventing disease in the future.[1]

Since ancient times, the study of fingerprints has fascinated scholars, doctors, and laymen alike. Human fingerprints are detailed, unique, difficult to alter, and durable over the life of an individual, making them suitable as long-term markers of human identity. Fingerprints have a major role to play during any disaster which helps in identifying people who are incapacitated or deceased. Cummins in 1926 first introduced the term “dermatoglyphics” which refers to the study of the naturally occurring patterns of the surface of the hands and feet of human beings.[2]

Through decades of scientific research, the hand has come to be recognized as a powerful tool in the diagnosis of psychological, medical, and genetic conditions. Genetically determined patterns remain unchanged from birth to death.[3] Dermatoglyphic analysis as claimed by several researchers can be an important diagnostic tool for oral diseases such as dental caries, oral cancer, bruxism, malocclusion, anomalies of teeth, cleft lip, cleft palate, periodontal disease, and dental fluorosis.[4],[5],[6],[7],[8],[9],[10],[11],[12],[13],[14],[15],[16]

Oral submucous fibrosis (OSMF) is a potentially malignant disorder with a high rate of malignant transformation.[17] It also shares a unique predisposition of occurrence in the Indian subcontinent due to the excess consumption of betel nut (Areca catechu).[17] The total number of cases of OSMF in India is around two million, however not all the people using betel nut (A. catechu) suffer from this disease.[17] Thus, there may be a certain genetic predisposition for this disease which can be predicted by using various cytogenic markers.

Thus, the present study was carried out with the aim to analyze the association between dermatoglyphics and OSMF and to compare the pattern with a control group.


  Materials and Methods Top


A cross-sectional study was carried out among patients visiting the Outpatient Department of Oral Medicine and Radiology, of a dental institute for over a period of 6 months from March to August 2014. The ethical clearance was obtained from Institutional Ethical Review Board. Patients were explained in detail about the study, and informed consent was obtained.

The sample size was determined using G*Power software Version 3.1.9.2 (Heinrich-Heine-Universität Düsseldorf) by assuming 80% power, 0.05 as alpha error and medium effect size. The total sample size of 39 was determined in this manner which was rounded off to 40. The study consisted of two groups, the study and control group. The study group consisted of 20 study subjects with a history of tobacco/areca nut intake with the occurrence of OSMF, and the control group consisted of 20 study subjects with habit of tobacco/areca nut but without any evidence of oral lesions.

Inclusion criteria

  • Subjects chewing tobacco/areca nut for more than 1 year with or without use of tobacco in other forms
  • Restricted oral opening with palpable fibrous bands and/or burning sensation of mucosa were included in the study group
  • Those having no palpable fibrous bands on clinical examination and/or burning sensation of mucosa (no signs or symptoms of OSMF) were included in the control group.


Exclusion criteria

  • Betel nut chewers with any other oral lesions
  • Presence of oral lesions due to other causes such as sharp tooth margins, improper restorations, prosthesis, alcohol, or smoking
  • Patients with scars or any injury to digits
  • Patients with any systemic diseases.


A structured format was designed, for the collection of demographic data, detailed history of habits and medical history. All the subjects underwent clinical examination by a single calibrated examiner (kappa: 0.92) for presence of OSMF Lesions. Those having the lesions were allotted to the study group and those who did not have any signs and symptoms of OSMF were allotted to the control group.

Another examiner who was unaware of the OSMF status of the subjects recorded the dermatoglyphic patterns of the subjects. Dermatoglyphic patterns of all 10 digits were recorded using Cummins and Midlo (1961) method.[18] Subjects were asked to wash their hands with soap and water to remove any dirt or oil. Palmer prints were taken by using standard ink method, using black duplicating ink (Kores India Limited., Mumbai, India). The subjects right-hand digits and left-hand digits was pressed in the ink pad followed by pressing it firmly against the bond paper.[19] In this way, a total of 400 digital prints (dermatoglyphic patterns) were obtained. The finger and palmer prints were analyzed qualitatively and quantitatively using Cummins, Midlo and Penrose method for arches, loops, and whorls.[20],[21]

The data were compiled using MS-Office Excel. Percentages of loops, whorls, and arches were calculated in both groups. Chi-square test was performed and P value was set at 0.05. The analyses were performed using statistical package SPSS for windows Version 10.5 (Chicago, SPSS inc.)


  Results Top


A total of 40 individuals with areca nut habit participated in the study, out of which 20 were confirmed cases of OSMF and the remaining 20 served as control.

The age distribution of the participants was equitable in both groups with highest number of people belonging to the age group of 35–44 years. The mean age of participants was 38.5 years and 34.5 years in control and study group, respectively [Figure 1].
Figure 1: Age distribution of both oral submucous fibrosis and control group

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Among the three patterns estimated, the number of loops showed only slight variation between the two groups. The percentage of loops was 30% in right and 38% in the left hand of subjects with OSMF respectively. The same was 33% and 27% in right and left hands of the controls. It was seen that the difference in the loop pattern in OSMF and control group was not significant in both the right and left hand [Table 1].
Table 1: Distribution of loops, whorls and arches among study and control group

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The whorl pattern among subjects having OSMF was 24% and 20% in right and left hand, respectively, and that among controls was 7% and 5%, respectively. The arch pattern among subjects having OSMF was 0% and 1% in the right and left hand respectively and that among controls was 8% and 7%, respectively. These differences were found to be statistically significant (P< 0.05).

[Table 2] shows the percentage distribution of whorls and arch patterns in individual fingers of the study group (OSMF). Among the two patterns estimated in individual fingers, it was seen that the ring fingers both right and left had the highest percentage of whorl pattern at 35% and 30 % respectively. This was followed by the right thumb and right index finger which had 25% of whorl patterns each. The arch pattern seen was very less wherein only the left index finger demonstrated presence of arches. In control group, the highest percentage of whorl pattern was seen in the right ring finger with 15% and the arch pattern was highest in the left thumb with 15%.
Table 2: Distribution of whorl and arch pattern in individual fingers of study and control group

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  Discussion Top


OSMF is a peculiar disease which is chronic, progressive, irreversible and precancerous in nature. It affects oral, oropharyngeal, and at times esophageal mucosa.[17]

Nutritional deficiencies and immunological processes play an important role in the pathogenesis of OSMF. The available epidemiological evidence indicates that chewing betel quid (containing areca nut, tobacco, slaked lime or other species) is an important risk factor for OSMF.[16] However, not all the patients with OSMF have a prolonged history of areca nut or tobacco consumption. It is said that genetic susceptibility is responsible for such variations. In the present study, dermatoglyphics was preferred as it is a handy scientific investigating tool that is noninvasive, quick, and inexpensive. It can be used as an effective genetic marker on the basis that, the epithelium of the primary palate, as well as finger buds, develop from the same site during 6–13th week of intrauterine life and both are ectodermal in origin.[4]

The age group of the present study was between 15 and 48 years which was similar to the study conducted by Rajendran (1994).[22] The present study emphasized only on the presence or absence of OSMF as a part of the oral component, and the severity of the disease was not assessed. The dermatoglyphic pattern is a genetic marker for OSMF, which can predict and help in the prevention of the disease at an early stage.

Very few studies have been conducted to ascertain role of dermatoglyphics and OSMF independently. Guptaand Karjodkar,[2] conducted a similar study to assess the role of dermatoglyphics in squamous cell carcinoma and OSMF. In the present study, the percentage of arches in study group was 0.5% as compared to 7.5% in controls with the habit. This finding was similar to that reported by Gupta and Karjodkar in terms of arch pattern – higher percentage was seen in controls (26.7%) as compared to OSMF patients (23.4%). However, the finding related to whorls pattern seen in the present study did not corroborate with that reported by Gupta et al.[2] and Tamgire et al.[23] as they reported higher percentage of whorl pattern in the control group as compared to the study group. The reverse of this was seen in the present study. This could be attributed to racial differences as anthropologically the races within India have evolved differently and above-mentioned studies were conducted in different regions.

In the present study, the loops cannot be used as a predictor for OSMF in an individual consuming areca nut. Individuals with OSMF had higher number of whorls pattern than control group suggesting that individual with whorls pattern have a greater propensity to develop OSMF if they have the habit. On the other hand, individuals in the control group had higher number of arches pattern than the OSMF group, suggesting that individuals with higher number of arches are less likely to develop OSMF in spite of having the habit. Due to scarcity of similar studies, it is prudent to consider these results with a certain degree of objectivity. Further studies have to be conducted to confirm the same.

The present study has a few limitations; the sample collected was less and in future studies advanced analysis such as the ridge analysis can be done for more accurate results. Multicentric studies can be conducted in larger population with age, sex, religion, and race matched controls.

The field of dermatoglyphics holds promising results for determining the genetic susceptibility of individuals to develop OSMF. Although the present study reveals significant results, the scope for further research remains open as there is a paucity of similar literature for comparisons. The current study opens newer avenues in the field of dentistry as it holds definite potential to diagnose dreaded diseases at an early stage in a cost-effective manner.


  Conclusion Top


The field of dermatoglyphics holds promising results for determining the genetic susceptibility of individuals to develop OSMF. Although the present study reveals significant results, the scope for further research remains open as there is a paucity of similar literature for comparisons. The current study opens newer avenues in the field of dentistry as it holds definite potential to diagnose dreaded diseases at an early stage in a cost-effective manner.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Kornman KS, Polverini PJ. Clinical application of genetics to guide prevention and treatment of oral diseases. Clin Genet 2014;86:44-9.  Back to cited text no. 1
    
2.
Gupta A, Karjodkar FR. Role of dermatoglyphics as an indicator of precancerous and cancerous lesions of the oral cavity. Contemp Clin Dent 2013;4:448-53.  Back to cited text no. 2
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Cummins H, Midlo C. Fingerprints, Palms and Soles: An Introduction to Dermatoglyphics. New York: Dover Press; 1961. p. 319.  Back to cited text no. 18
    
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Tamgire DW, Fulzele R, Chimurkar VK, Rawlani S, Sherke AR. Qualitative dermatoglyphic analysis of fingertip patterns in patients of oral sub mucous fibrosis. J Dent Med Sci 2013;6:24-7.  Back to cited text no. 23
    


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