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Vatsala A R and Ajay K T: Comparative study of pulmonary function test and dermatoglyphics in eczem a patients


Introduction

Eczema is a chronic inflammatory skin condition characterized by very dry skin with scaly, crusted or hard like patches and symptoms can range from mild to severe degrees of acanthosis.1 Stress can contribute to flare up and exacerbate symptoms. Even low humidity, certain foods, overheating may aggravates eczema. Ways to reduce stress like by practicing yoga and controlling factors in the environment by minimizing or eliminating triggers can help to reduce the eczema flare ups.2

The word ‘eczema’ is also used specifically to talk about atopic dermatitis. Atopic refers to collection of diseases involving immune system, including atopic dermatitis, asthma and hay fever.3 Scientists has worked and reported that children with eczema are prone more in developing asthma and this development from eczema to asthma and respiratory problems as termed as ‘atopic march'.4

Population spirometric screening in eczema proven in Poland proved to be an effective method for early diagnosis of COPD and eczema. It was observed that Peak Expiratory Flow Rate (PEFR) and Forced Expiratory Volme in the first second (FEV1) parameters of lung function tests were reduced significantly among eczema compared to normal.5

Dermatoglyphics is a study of palm print which explains the, lines and shapes of hands, fingers, and toes. Each dermatoglyphic pattern is unique, right hand pattern will be different from left hand. It may grow in size from age to age, but never change and get destroyed if a person is seriously injured.6 Fingerprints will begin to grow again along with healing of the wound.7

Environmental factors and genetic factors definitely play a role in fingerprint formation. Ridge pattern development not only depends on genetic factors but also depends on shape of the mothers uterus and volume and density of amniotic fluid.8 The growth and activity of foetus and developmental conditions of mothers uterus prevent fingerprints from developing the same way in fetuses of identical twins, because of this identical twins have same gene code but different fingerprints. The condition called ‘adermatoglyphia’, in which individuals do not have dermatoglyphis prints.9

Apart from its use in predicting the diagnosis of genetic disease, dermatoglyphics is also used in Forensic science for individual identification. It is also a valuabe research tool in the field of Physical Anthropology, Human Genetics and Medicine.10 Dermatoglyphics multiple intelligence test which is done by counting of ridge pattern of palms and fingers. And this can be used for clinical evaluation and for screening in the field of psychology, medicine and anthropology.11

Considering all these factors the present work is an attempt to study the correlation between dermatoglyphics and eczema and lung function test in eczema and it assumes a great importance to prevent and avoid possible lung complications and also helps in early detection of COPD in eczema.

Fingertip patterns

Galton F divided fingertip patterns into 3 groups - Loops, Arches and Whorls.12

Arch

An arch is the simplest pattern. It is hill- shaped, curved top, no triangle was formed in with the shape.

  1. Simple arch pattern

  2. Tented arch pattern12

Figure 1

Showing different finger tip patterns

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Loop

It is like a waterfall flowing toward radial or ulnar side.

  1. Ulnar Loop pattern : In Ulnar Loop ridges opens on the ulnar side.

  2. Radial Loop pattern : In Radial Loop ridges open on the radial side.

Figure 2
https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/a075107c-538c-4c25-8f90-81337bb2dd27/image/70c628d2-ab65-459b-babd-26f4d3a0d45f-u58.png

Whorls (W)

Whorls are pattern where lines starts from centre of small circle and turns into concentric circle, or into long oval shape and has two triangular points.12

Figure 3
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Axial triradius

The triradius to wards palmar axis are termed as Axial triradius(t).

‘atd’ angle: It is finger print trait formed by lines drawn between thenar triradii to last digits triradii and on to hypothenar triradii. The purpose of examining this gives measurement reliability.

Methodology

The study was conducted on 50 eczema patients, 25 male and 25 females in J.J.M. Medical College Hospital who were attending the dermatology OPD, and were compared with 50 normal individuals, 25 male and 25 females.

The study was conducted over a period of one year. Written informed consent was taken from the subjects for their participation for the study, Institutional ethical clearance was obtained.

Lung function Parameter PEFR was done using standardized RMS Wrights Peak Flow Meter. The inclusion criteria of the study was non smoking adult male aged between 20 to 40yrs and females between 20-40 yrs and who are not suffering from any lung diseases and people who had a history of smoking and any lung diseases were excluded. The male subjects were asked to Blow forcefully into the wrights Peak Flow Meter with a nose clamp twice with an interval of 5 mins, The best value was considered. The results were given as Mean ± SD and comparison was done using student t test

Dermatoglyphics analysis procedure – Modified Purvis smith Method

The hands were thoroughly washed with hand wash and dried neatly and required amount of camel ink was poured on the glass slab and was spread by the rubber roller to get a thin neat uniform ink film. Ink is applied to palm by passing the roller over the palm and digits and uniformly stamp on a paper by pressing palm gently. The fingerprints were taken starting from thumb to little fingers of right hand and similarly repeated for left hand. Then the prints were scanned into computer and calculate the fingerprint pattern and analyze the number of prints in order to understand genetic sequences. For qualitative analysis “Chi” square test is applied

Results and Discussion

Table 1
Pattern Total value in Eczemapt (In Nos) Total value in Control (In Nos) Chi-square value P-value
Arches 31 20 2.1 0.145
Ulnar loops 358 461 19.20 0.0002
Radial loops 11 28 3.95 0.056
Whorls 148 181 4.47 0.0321

Comparison of dermatoglyphic patterns between male eczema patients & controls

[i] X2 = 2.1, P= 0.145 X2 =3.95, P= 0.056

[ii] X2 = 19.2, P= 0.0002 X2 = 4.47. P=0.0321

Table 2
Pattern Total value in Eczema Patient (In Nos) Total value in Control (In Nos) Chi-square value P value
Arches 8 33 18.908 0.0001
Ulnar loops 161 179 0.37 0.61
Radial loops 11 14 0.74 0.321
Whorls 121 91 4.409 0.031

Comparison of dermatoglyphics patterns between female eczema patients & controls

[i] X2 = 18.9, P= 0.0001 X2 =0.74, P= 0.32

[ii] X2 = 0.37, P= 0.61 X2 = 4.40. P=0.031

Table 3
Hand Male Eczema pts Male controls Female Eczema pt Female controls
Right hand 36.89 40.95 44 44.9
Left hand 44.28 47.81 36.2 49.8

Comparing mean of atd angle in male eczema patients and female eczema patients with the controls

Table 4
Groups n Actual value (L/sec)
Range Mean ± SD
Normal male 25 5.40 -10.6 8.3 ± 0.92
Eczema Pt Male 25 4.16- 7.64 5.8 ± 0.7
Mean difference 2.40
Significance p < 0.001 HS

Comparison of PEFR between male normal and Eczema patients

[i] All values expressed as Mean±SD

[ii] HS – Highly significant

Table 5
Groups n Actual value (L/sec)
Range Mean ± SD
Normal Female 25 4.30 -8.46 6.2 ± 0.82
Eczema Pt Female 25 3.28- 6.84 4.6 ± 0.5
Mean difference 1.60
Significance p < 0.001 HS

Comparison of PEFR between Female normal and Eczema patients

[i] All values expressed as Mean±SD

[ii] HS – Highly significant

Table 1 In the present study table no 1 shows more number of total arches in male eczema patients compare to normal individuals were found. Eczema male patients showed significant increase number of ulnar loops as compared to controls. Whorls pattern were found less in eczema. The results were statistically significant.

Table 2 In the present study table no 2 showed statistically significant decrease in number of total arches in female eczema patients compare to normal individuals. Whorls pattern of female eczema patients were also decreased as compared to controls and this difference were statistically significant.

Table 3 Out of 25 eczema male patients and female patients majority showed meanatd angles were lesser in both hands when compared to male controls and female control and this results showed statistically very significant.

Table 4 25 eczema male patients showed a mean decrease of 2.4L/sec in the PEFR when compared to 25 male controls and this results were statistically very significant.

Table 5 25 eczema female patients showed a mean decrease of 1.6L/sec in the PEFR when compared to 25 female controls and this results were statistically very significant.

Discussion

Dermatoglyphics reveals the congenital links between fingers and intrinsic qualities, behaviour and talent s of an indivisual13 Dermatoglyphics has a absolute scientific basis with 200 years of research history. This can be analyzed and proven clinically with evidence in anthropology , genetics, medicine and statistics.

Medical Scientists in US, Japan etc have applied der matoglyphics in the diagnosis of Congenital disorders like Turners’s Syndrome, genetic abnormalities and in educational fields. Many scientists and medical doctorate found that the born number of brain cells can be checked from the various dermatoglyphics pattern.14

The Frequencies of various types of skin ridges in patients of 50 eczema & 50 controls were examined in or study. The frequency of distribution of dermatoglyphics ridge patterns in both hands of eczema patients showed significantly decrease in arches when compare to controls. Whorl pattern showed a significantly decrease in number in eczema patients when compared to controls.

Fingerprint pattern were observed on various diseases such as ichthyosis, atopic dermatitis, eczema, anhidrotic ectodermal dysplasia and various skin diseases. A study on dermatoglyphics in malignant skin diseases and in patients with psorias is, eczema showed differences in arches and whorl pattern which is similar to our study.8

Dermatoglyphics of each individual are unique has been utilized to identify people with the genetic predisposition to develop eczema and various skin diseases, to determine significant fingerprint pattern applicable for eczema and to develop inexpensive tool for inspecting skin ridges and screening for eczema and asthma and they reducing mortality and morbidity.10

Our result of decreased PEFR in the eczema were similar to other studies which showed a decrease in lung functions in eczema patients and this can be explained as constriction and inflammation of airway which leads to decrease in elastic recoil pressure of the lungs.15

Conclusion

From our study we can conclude that dermatoglyphics is most inexpensive important tool and therefore promised to provide simple means for medical investigations and it will help in genetic counseling in relation to eczema and other various dermatoses diseases and may be used to predict the future eczema.

Our study is by no means exhaustive but the limitation of the study is less studies done in dematoglyphic and further many quantitative study are needed in this aspects but the strength is the study establishes there is a random relation between dermatoglyphic pattern, eczema And lung functions and we conclude that population with decreased arches in both hands may develop eczema and hence we recommend for these people to do more of respiratory exercise and periodic monitoring of pulmonary function test.

Source of funding

None.

Conflict of interest

None.

References

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