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 Table of Contents  
REVIEW ARTICLE
Year : 2017  |  Volume : 7  |  Issue : 1  |  Page : 2-7

Revival of dermatoglyphics: Syndromes and disorders, a review


1 Department of Oral Medicine and Radiology, Sri Sai Dental College and Research Institute, Srikakulam, Andhra Pradesh, India
2 Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India

Date of Web Publication6-Feb-2017

Correspondence Address:
Abhishek Singh Nayyar
44, Behind Singla Nursing Home, New Friends' Colony, Model Town, Panipat, Haryana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-8568.199528

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  Abstract 

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 amazing qualities, these dermal ridges play a very crucial and important role in the personal identification of an individual, for forensic purposes, in twin diagnosis, racial variation and have applied values in various diseases and syndromes. Dermatoglyphics has, therefore, been accepted as a simple and inexpensive method for deciding whether a patient would have a particular genetic or, chromosomal defect or, not, and if so, to adopt the preventive strategies at the early enough stages.

Keywords: Dermatoglyphics, epidermal ridges configurations, various diseases and syndromes


How to cite this article:
Lakshmana N, Nayyar AS, Pavani B V, Ratnam M, Upendra G. Revival of dermatoglyphics: Syndromes and disorders, a review. Adv Hum Biol 2017;7:2-7

How to cite this URL:
Lakshmana N, Nayyar AS, Pavani B V, Ratnam M, Upendra G. Revival of dermatoglyphics: Syndromes and disorders, a review. Adv Hum Biol [serial online] 2017 [cited 2020 Mar 29];7:2-7. Available from: http://www.aihbonline.com/text.asp?2017/7/1/2/199528


  Introduction Top


Dermatoglyphics deals with the study of the epidermal ridges and their configurations on the fingers, palms and soles.[1] The word dermatoglyphics is derived from the Greek word 'Derma' meaning skin and 'glyphics' meaning carvings.[2] Fingerprints or, dermatoglyphics consist of patterns formed by parallel ridges on the bare skin of fingertips. They are typical for higher primates, but occur sporadically in other mammals.[3] The skin on the palmar and plantar surfaces of human beings though is not smooth. It is grooved by curious ridges, which form a variety of configurations.[4] The dermatoglyphic patterns of dermal ridges that constitute human fingerprint are formed during the early intra-uterine life, between 7th and 21st week of gestation and mature at about 7 months of fetal development.[2],[3],[5] Dermatoglyphics, once matured, remain unchanged throughout the life of an individual and are not influenced by either the environmental or, age-related factors.[2],[5] Certain factors such as inadequate blood/oxygen supply, unusual distribution of sweat glands and alterations in the epithelial growth although in addition to bruises and cuts of the fingertips could influence these ridge patterns.[3] These finger and palmar prints are permanent variables and inherited, differ amongst parents and their children, siblings and even in, monozygotic, identical twins. Because of these amazing qualities, these dermal ridges play a very crucial and important role in the personal identification of an individual, for forensic purposes, in twin diagnosis, racial variation and have applied values in various diseases and syndromes.[6] The development of these dermal ridges has been found to be affected by genetic and environmental factors during the developmental stages. Dermatoglyphics has, therefore, been accepted as a simple and inexpensive method for deciding whether a patient would have a particular genetic disorder or, not and any chromosomal defect.[7]

History of dermatoglyphics

Archaeologists have discovered fingerprints pressed into clay tablet contracts dating back to 1792–1750 B.C. in Babylon. In ancient China, it was a common practice to use inked fingerprints on all official documents such as contracts and/or, loans. The oldest known document showing fingerprints dates from the third century B.C. Chinese historians have found finger and palmar prints pressed into clay and wood writing surfaces and have summarized that they were used for official seals and legal documentations.[8] Johann Christoph Andreas Mayer followed this work in 1788 by describing that 'the arrangement of skin ridges is never duplicated in two persons'. He was probably the first to recognize this fact. Dermatoglyphics is the scientific study of papillary ridges in the palm of the hands and soles of the feet (Purkinje 1823).[9] For nearly a century and a half, there were no notable advances although in 1823, Jan Evangelist Purkyn described nine distinct fingerprint patterns including loops, spirals, circles and double whorls.[10] The importance of dermatoglyphics for practical purposes dates back to ancient China (1839) where it was used in the sale of the land. The deal of the land carried the impression of the finger prints as an acknowledgement of the deal.[5] Sir William Herschel began the collection of fingerprints in 1856. He noted the patterns to be unique to each person and not altered by age.[8] The first systematic study of the whole subject, however, was carried-out by Francis Galton around the year 1892. He divided the ridge patterns on the distal phalanges of the fingertips into three groups namely, arches, loops and whorls.[4],[9] Lauter (1912) provided the history of the fingerprint system. Hersched (1916) traced the origin of the fingerprints. Cummins (1927) found the impression of a thumb print on clay. Heindl (1929) reported the first fingerprint for identification purposes in Germany.[5] Cummins (1930) exhibited the first fingerprint carving of the stone age. De Forest (1930) traced dactyloscopy in the United States of America. Wilton (1938) published a book, Finger Prints History, Law and Romance. Myers (1939) provided the history of identification of fingerprints. Penrose (1968) finally drafted the memorandum on dermatoglyphics nomenclature.[5]

Embryology of dermatoglyphics

Dermal ridge differentiation takes place early in fetal development. Ridges develop in relation to the volar pads. The resulting ridge configurations are genetically determined and influenced only by genetic and environmental factors during their developmental stages. Fetal volar pads are mound-shaped elevations of the mesenchymal tissues situated above the proximal ends of the most distal metacarpal bones on each finger, in each interdigital area, in the Thenar and hypothenar (HY) areas of the palms and soles, and in the calcar area of the soles. The formation of these pads is first visible on the fingertips during 6th–7th week of embryonic development. The pads become very prominent during the subsequent weeks, diminish in the 5th month while disappearing completely in the 6th month. Within this period, the dermal ridges coalesce into specific patterns, replacing the volar pads. The presence of the volar pads as well as their size and position are to a large extent responsible for the configuration of papillary ridge patterns. For example, small pads would result in a simple pattern (arch) whereas more prominent pads would tend to lead to the development of larger and more complex systems of ridge configurations including loops and whorls.[11],[12] The epidermal ridge patterns are completed only after the sixth pre-natal month when the glandular folds are fully formed and after the sweat gland secretion and keratinization starts. At around this time, the configurations on the skin surface begin to reflect the underlying patterns. The surface epidermal furrows correspond to the furrow folds of the stratum germinativum and each epidermal ridge is formed above a glandular fold.[12] Several hypotheses have been formulated concerning the forces that are responsible for the development of these specific ridge patterns. Few have speculated that the dermal ridge configurations are the result of physical and topographic growth forces. It is believed that the tensions and pressures in the skin during early embryogenesis determine the directions of the epidermal ridges.[12] Some studies have also described that the arrangement of blood vessels and nerve pairs under the smooth epidermis exists shortly before glandular folds and have speculated that the folds are induced by the blood vessel-nerve pairs.[11] Cummins (1935) observed the ridge configurations of congenitally malformed hands and proposed that the direction of epidermal ridges is determined by growth forces and the contour of volar skin at the time of ridge formation.[11],[12]

Dermatoglyphic pattern configurations in fingers

The ridge patterns on the distal phalanges of the fingertips are divided into three groups: Arches, loops and whorls [Figure 1].[4],[11] Arches are formed by a succession of more or, less parallel ridges which traverse the pattern area and form a curve that is concave proximally [Figure 1]a. The arch patterns are sub-divided into two types: The simple (or, plain) arch (A) pattern which is composed of ridges that cross the fingertips from one side to the other without recurring and the more intricate type, wherein, the ridges meet at a point, so that, their smooth sweep is interrupted and a tented arch (T) is formed.[4],[11] The most common pattern on the fingertip is the so-recognized loop pattern [Figure 1]b. In this configuration, a series of ridges enter the pattern area on the same side. If the ridges open-up on the ulnar side, the resulting loop is termed as ulnar loop while if they open-up towards the radial margin, it is termed as a radial loop. A loop has a single triradius which is located laterally on the fingertip and always on the side, where the loop is closed.[4],[11] The ridges in a simple whorl are commonly arranged as a succession of concentric rings. Such patterns are described as concentric whorls [Figure 1]c. Also, they might be seen in a different configuration with spirals around the core in either a clockwise or, a counter clockwise direction and this type of pattern is called as a spiral whorl.[4],[11]
Figure 1: (a) Arch, (b) Loop and (c) Whorl patterns.

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Dermatoglyphic landmarks

The basic dermatoglyphic landmarks found on the fingertip patterns are the triradii and cores. Triradii are formed by the confluence of three ridge systems [Figure 2]. The geometric center of a triradius is designated as the triradial point. The triradial point forms one terminus of the line along which ridges are counted. These are commonly observed in the HY areas of the palms.[4] Another important landmark employed in ridge counting is the core which is in the approximate center of the pattern. The cores may be of different shapes. In a loop pattern, the core is usually represented by a straight, rod-like ridge or, a series of two or, more such parallel ridges over which other recurring ridges pass. If a straight ridge is absent in the center of the loop, the innermost recurring ridge is designated as a core. In a whorl, the core can appear as a dot or, a short ridge (either straight or, bent) or, it can be shaped as a circle or, an ellipse in the center of the patterns. In ridge counting, not the whole core, but the point of core only is used. The point of core is at the distal tip of the straight line forming the core. When the innermost recurring ridge contains no ending ridge, the point of core is placed on the shoulder of the loop farther from the triradial point. The shoulders of a loop are the points at which the recurring ridge definitely curves. When an even number of rod-like ridges is present, the point of core is placed on the end of one of the two center ridges farther from the digital triradius. If there are two straight ridges within the innermost recurring ridge, one of which does not rise as high as the shoulder of the loop, the tip of the other ridge is chosen as the point of core. When an uneven number of rods make up the middle of the pattern, the point of core is the tip of the central rod-like ridge. The recurring ridges representing the core must have no appendage connected perpendicularly to their tip on the outside. In presence of such an appendage, the loop is considered spoiled and the next loop outside is considered in locating the point of core. Also, two recurring ridges side by side at the center of the pattern are treated as one loop with two rods within the re-curve. The rod, farther, from the triradius, in such a case, is chosen as carrying the point of core.[4]
Figure 2: Triradial point.

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Dermatoglyphic palmar pattern configurations

The palm has been divided into several anatomically defined areas including Thenar area, four interdigital areas and the HY area. Thenar and first interdigital areas (TH/I1) are closely related anatomically and are considered as TH/I1. Patterns, when present, are most often loops. Second, third and fourth interdigital areas are found in the distal palm in the region of the heads of the metacarpal bones. Each interdigital area is bordered laterally by digital triradii. The digital triradii are almost always located proximal to the base of digits II–V. Digital triradii are labeled a, b, c and d starting from the triradius located at the base of digit II and moving toward the triradius associated with digit V. Second interdigital area (I2) lies between the triradii a and b; the third interdigital area, (I3), between triradii b and c; while the fourth interdigital area, (I4) between triradii c and d. Patterns seen in HY area, most commonly, include whorls, loops and tented arches [Figure 3]. Many dermatoglyphic characteristics can be described quantitatively, viz., by counting the number of triradii or, ridges within a pattern and measuring distances or, angles between the specified points.[13],[14] Ridge counting is used to indicate the pattern size. It is primarily utilized on the fingertips and toes as a way of expressing the distance between digital triradii and/or, the ridge density in a given area. The count is done along a straight line connecting the triradial point to the point of core. The ridges containing the point of core and the triradial point are both excluded from the count. Whorls that possess two triradii and atleast, one point of core allow two different counts to be made, one from each triradius. Because the ridge counts are used to express the pattern size, only the largest count is scored in a pattern with more than one possible count. Both simple and tented arches have zero counts.[13],[14] Total finger ridge count (TFRC) represents the sum of the ridge counts of all ten fingers where only the larger count is used on those digits with more than one ridge count. ab ridge counting is carried-out along a straight line connecting both (a and b) triradial points [Figure 4]. atd angle is formed by lines drawn from the digital triradius (a) to the axial triradius (t) and from this triradius to the digital triradius (d) [Figure 5]. Sometimes accessory 'a' or, 'd' triradii are present on the palm.[4],[13],[14]
Figure 3: Palmar pattern configurations.

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Figure 4: Ab ridge.

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Figure 5: Atd angle.

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Methods of printing: Three methods of printing have been used for taking prints:

  • Inkless methods (Walker 1957)
  • The Holister system for the young and new born infants
  • The Indian ink method (Cumins and Midlow, 1961).


Inkless methods (Walker 1957)

MacArthur and Ford (1937) described a procedure for making prints in the latent form from face cream which was spread on a kymograph paper. The latter was fixed in shellac after developing an impression with lamp black fine powder. This saved the subject from the inconvenience of the staining or, the discoloration of the hands.[15] The X-ray (Roentgen's method) has scored its useful value over other unsuccessful techniques for finger prints in the advanced states of decomposed bodies. X-ray records are used for the indirect correlation of the position of the triradii and the hand skeleton by fastening lead pallets with adhesives at the point of the triradii.[15] Castellanos (1939) mentioned Beclare's procedure which consisted of smearing the skin with lanolin and bismuth carbonate and taking shadow graphs by the usual X-ray method.[15]

The Holister system for the young and new born infants

In infants, prints have been developed on photographic paper from a moistened blotter which is pressed against the fingers and passed through a developing mixture which is prepared from a stock solution which consists of sodium sulphide, NaoH, starch and distilled water. This is made permanent by fixation in hypo solutions.[15]

Ink methods

One of the best known and most widely used methods utilizes printer's ink and a good quality paper along with a roller, a glass and/or, metal inking slab and a sponge rubber pad. A small amount of ink is spread over the slab with the roller into a thin, even film. The area to be printed is pressed against the slab and then, pressed against the paper placed over the rubber pad.[1],[15]

Dermatoglyphic studies in various systemic disorders

Neiswanger et al. conducted a case control study in Chinese individuals with non-syndromic cleft lip with or, without cleft palate (CL/P) and the control groups. Increased radial and ulnar loops were observed in cleft lip and palate patients.[16] Sugerman et al. observed wider atd angles.[17] Mathew et al. found an increased frequency of ulnar and radial loops than the arches and whorls in cleft lip with or, without cleft palate patients compared to controls.[16] Imene Namouchi conducted a study on Tunisian population to analyze eventual differences between men and women and between individuals according to their geographical distribution. The Chi-square test revealed highly significant differences between the sexes for the frequencies of arches in case of fifth finger and for the frequencies of loops in case of fourth left finger and the first left finger. The difference of distribution of the whorl pattern between men and women was statistically significant for the fourth left finger while no significant difference was found between sexes in regards of finger ridge counts.[3] Luna and Pons et al. conducted a study and described an Eastern Andalusia population by more of the whorls and radial loops in males while arches and ulnar loops in females.[3] Igbigbi and Msamati et al. investigated the South African populations with regards to the digital patterns. In Zimbabwean subjects, ulnar loops were the most predominant pattern type in both sexes followed by whorls in males and arches in females; however the sex differences between the digital pattern types were not found to be statistically significant.[3] Sontakke et al. found significant reduction of loops in Klinefelter's syndrome patients (31.7%) as compared to that of controls. A significant increase of whorls in Klinefelter's syndrome patients (66.7%) as compared to that of controls (35.0%) was also observed. A similar finding was reported by a study on Japanese patients with Klinefelter's syndrome.[18] Bhargava et al. conducted a study on dental caries group and found highly significant differences in the distribution of loops between the subjects (dental caries group) as against the control group and also observed significant differences between the subjects and control groups for the microbial growth.[4],[19] Ramesh et al. observed TFRC and atd angles with a significant increase in sickle cell anemia patients concluding sickle cell anemia to have dermatoglyphic correlation and that the same could be considered as marker for male as well as female patients as the diagnostic tool in linking sickle cell anemia to dermatoglyphics.[20] Padmini Pramila et al. observed an increased incidence of atd angle in male diabetics than the controls although no significant difference was observed for the same in female patients as against the controls.[7] On the contrary, Verbov et al. in a study found an increased arch pattern in female diabetic patients only. Sant (1983) reported a significant increase in the frequency of whorls and decrease in ulnar loops in diabetics of both sexes and found a significant increase in arch pattern in female diabetes only. Inamdar Vaishali et al. (1995), in his study with 158 Insulin Dependent Diabetes Mellitus (IDDM) children with limited joint mobility, found a higher frequency in the number of arches in the patients than in the controls.[7] Ravidranath et al. (1995) observed, in a study on 150 non-NIDDM patients, an increase in the ulnar and radial loops and a decrease in whorls in diabetics of both the sexes.[7] Padmini Pramila et al. also observed an increased incidence of variations in ulnar loops, simple arches, composite whorls and double pocket whorls in diabetic patients than in the controls.[7] Igbigbi and Msamati et al., in their study in 2002 on sub-Saharan Africans, also showed the values of TFRC found among the Zimbabweans to be higher in the men than in women. These results were also comparable to those obtained in the Zulus of South Africa.[3] Igbigbi and Msamati et al., in their study in 1999 on Southern Nigerians, stated the Southern Nigerians to have a significantly higher TFRC than those previously reported for the Zulu. In Malawian subjects, women had significantly higher TFRC than men.[3] Arunpongpaisal and Nanakorn, in their study, showed that only male schizophrenics had a significantly less proportion of whorl pattern than the controls, the findings which were consistent with the Paez's study.[21] Schauman and Mayersdorf et al. found an increase in radial loops in white adults with idiopathic epilepsy.[22] Andani Rashida and et al., in their study, showed 'atd' angle to be wide in Thalassemia patients in comparison to the controls.[23] Singhal Manju D and Gandotra A showed a significant difference of atd angle in the right hand in leprosy patients as compared to the control group. The findings of the study, however, revealed significant differences of the atd angle in the left hand in leprosy patients as against the control group.[24] Bukelo et al. reported an increase of arches and a decrease of ulnar loops in the fingertips of a group of patients with an acute blast cell leukemia.[25] Ramesh et al. observed a significant increase in TFRC and atd angle sickle cell anemia patients as against the controls.[21] Reddy et al. also reported an increase in TFRC (P < 0.001) in carcinoma cervix patients as compared to controls.[21] Inamdar Vaishali et al. conducted a study on ninety histopathologically established females of cancer cervix and ninety normal healthy females (control group). In both patients and controls, the age-range was between 25 and 65 years. The results of the study showed a significant increase in the frequency of whorls and TFRC in both hands and an increase in the frequency of arches in left hand with a significant decrease in atd angle and ridge count and frequency of ulnar loops in both hands of females having carcinoma of cervix as compared to the controls. There was no significant difference although that could be observed in relation to other parameters like a-b, b-c, c-d ridge counts and radial loop frequency between the patients and controls.[21] Andani Rashida and et al., in their study, showed 'atd' angle to be wide in Thalassemia patients in comparison to the controls.[23] Bukelo Mario Joseph et al. conducted a study on patients with acute lymphoblastic leukemia and controls. The results of the study showed the mean ab ridge count and the mean atd angle to be higher in cases than the controls.[25]


  Conclusion Top


The study of dermatoglyphics dates back to 1792–1750 B.C. although the exact use of the same as far as their role in diagnosis of various disorders is concerned has still to be searched. 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. Because of these unique features, these dermal ridges play a very crucial and important role in the personal identification of an individual for forensic purposes. The role of dermatoglyphics is established in forensic purposes, however, their role as a diagnostic tool still remains debatable with want of further research, although, a number of studies have given initial convincing results. Dermatoglyphics, therefore, still has to establish itself as a potent, simple and inexpensive tool in the diagnosis of various genetic and chromosomal disorders and if so, it will be one of its kind of investigative tool that will help prevent dreaded diseases early in their course or, before actual onset with the adoption of appropriate measures to check-in the disease before it actually set-in or, leads to dreaded sequel.

Acknowledgement

To all the patients who contributed in the study without whom this study would not have been feasible.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Venkatesh E, Anjana B. Palmar dermatoglyphics in oral leukoplakia and oral squamous cell carcinoma patients. J Indian Acad Oral Med Radiol 2008;20:94-9.  Back to cited text no. 1
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Namouchi I. Anthropological significance of dermatoglyphic trait variation: An intra-Tunisian population analysis. Int J Mod Anthropol 2011;4:12-27.  Back to cited text no. 3
    
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Soni A, Singh SK, Gupta A. Implications of dermatoglyphics in dentistry. J Dentofacial Sci 2013;2:27-30.  Back to cited text no. 4
    
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Kumbnani HK. Dermatoglyphics. In: Bhasin V, Bhasin MK, editors. Delhi: Kamla-Raj Enterprises; 2007.  Back to cited text no. 5
    
6.
Padmini Pramila M, Rao Narasinga B, Malleswari B. The Study of dermatoglyphics in diabetics of North Coastal Andhra Pradesh population. Indian J Fundam Appl Life Sci 2011;1:75-80.  Back to cited text no. 6
    
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Inamdar Vaishali V, Vaidya SA, Pratima K, Devarshi DB, Shailesh K, Tungikar Sudhir L. Dermatoglyphics in carcinoma cervix. J Anat Soc India 2006;55:57-9.  Back to cited text no. 7
    
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Galton F. Finger prints. London: McMillan; 1982.  Back to cited text no. 8
    
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Osunwoke EA, Ordu KS, Hart J, Esomonu C, Tamunokuro FB. A study on the dermatoglyphic patterns of Okrika and Ikwerre ethnic groups of Nigeria. Sci Afr 2008;7:143-7.  Back to cited text no. 9
    
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Birnholz JC. Dermatoglyphics in congenital heart disease. Am J Roentgenol Radium Ther Nucl Med 1972;116:539-47.  Back to cited text no. 10
    
11.
Ramani P, Abhilash PR, Sherlin HJ, Anuja N, Premkumar P, Chandrasekar T, et al. Conventional dermatoglyphics- Revived concept: A review. Int J Pharma Bio Sci 2011;2:446-58.  Back to cited text no. 11
    
12.
Babler WJ. Embryologic development of epidermal ridges and their configurations. Birth Defects Orig Artic Ser 1991;27:95-112.  Back to cited text no. 12
    
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Zhou Y, Zeng Y, Lizhen, Hu W. Application and development of palm print research. Technol Health Care 2002;10:383-90.  Back to cited text no. 13
    
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Park JS, Shin DS, Jung W, Chung MS. Improved analysis of palm creases. Anat Cell Biol 2010;43:169-77.  Back to cited text no. 14
    
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Sharma MK, Hemlata D. Dermatoglyphics: Diagnostic tool to predict diabetes. J Clin Diagn Res 2012;6:327-32.  Back to cited text no. 15
    
16.
Neiswanger K, Cooper ME, Weinberg SM, Flodman P, Keglovits AB, Liu Y, et al. Cleft lip with or without cleft palate and dermatoglyphic asymmetry: Evaluation of a Chinese population. Orthod Craniofac Res 2002;5:140-6.  Back to cited text no. 16
    
17.
Sugerman PB, Savage NW, Walsh LJ, Zhao ZZ, Zhou XJ, Khan A, et al. Oral lichen planus: Causes, diagnosis and management. Aust Dent J 2002;47:290-7.  Back to cited text no. 17
    
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Sontakke BR, Ghosh SK, Pal AK. Dermatoglyphics of fingers and palm in Klinefelter's syndrome. Nepal Med Coll J 2010;12:142-4.  Back to cited text no. 18
    
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Bhargava SS, Sathawane RS. Dermatoglyphics: Exploring newer dimensions in diagnosis. Cent India J Dent Sci 2012;3:126-32.  Back to cited text no. 19
    
20.
Ramesh M, Kumari KG, Kalpana VL, Sudhakar G. Palmar and digital dermatoglyphic patterns in sickle cell anemia patients of North Coastal Andhra Pradesh, South India. J Anthropol 2012;8:23-32.  Back to cited text no. 20
    
21.
Arunpongpaisal S, Nanakorn S. Dermatoglyphic traits in Thai schizophrenia patients: A matching case-control study. J Thai Med Assoc 2011;94:386-94.  Back to cited text no. 21
    
22.
Mattos-Fiore MA, Saldanha PH. Dermatoglyphics in juvenile epilepsy. Braz J Genet 1996;19:151-63.  Back to cited text no. 22
    
23.
Andani Rashida H, Dharati K, Ojaswini M, Nagar SK, Kanan U, Bhaskar P. Palmar dermatoglyphics in patients of thalassemia major. Natl J Med Res 2012;2:287-90.  Back to cited text no. 23
    
24.
Singhal Manju D, Gandotra A. An early predictor in leprosy: The ATD angle. J Anat Soc India 2010;59:201-4.  Back to cited text no. 24
    
25.
Bukelo MJ, Kanchan T, Rau AT, Unnikrishnan B, Bukelo MF, Krishna VN. Palmar dermatoglyphics in children with acute lymphoblastic leukemia – A preliminary investigation. J Forensic Leg Med 2011;18:115-8.  Back to cited text no. 25
    


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



 

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