Dermatoglyphic Pattern Assessment in Smokeless Tobacco Users in the North Gujarat Population: A Comparative Case–Control Study

ABSTRACT

Introduction:

Dermatoglyphic patterns identify genetic conditions as they develop early in pregnancy and remain constant throughout life. Multiple studies suggest that there is a genetic link to smokeless tobacco use. So, this study has been conducted to assess dermatoglyphic patterns among smokeless tobacco users in the North Gujarat population with nonconsumers

Materials and Methods:

A total of 500 cases were investigated for “ATD” angle and patterns, of which 250 subjects of smokeless tobacco are assessed for statistical significance via comparing them to 250 subjects of nonconsumers. Student’s t-test was employed for evaluating quantitative factors (also known as the “ATD” angle), and the Chi-square test was used to analyze qualitative variables (also known as fingerprint patterns). A P value of 0.05 or less was considered significant.

Results:

In this study, the angle “ATD” was found to be reduced in both the palms of males (P 0.001) and females (P 0.001) when compared to controls, which was statistically highly significant. In our study, we discovered that the number of whorls and arches is lower in male cases as compared to male controls, which is highly significant (P = 0.020 and P = 0.010). Male cases had a greater number of loops than male controls, which was statistically significantly greater (P 0.001)

Conclusion:

In this latest study, an association between smokeless tobacco users and palmar dermatoglyphics was identified. Though dermatoglyphics solely is unable to identify individuals who abuse alcohol and/or cigarette packs, the results of this research could serve to further develop diagnostic guidelines.

INTRODUCTION

The term dermatoglyphics was first coined by Cummins in 1926. It is a term that refers to “a skin carving.”[1] These patterns can be used to distinguish one person from another because they are easily classifiable and recognizable. These dermatoglyphic traits embryologically develop between the 10^th and 17^th weeks of life; hence, the stability of prenatal development may be reflected in dermatoglyphic features. Most notably, they do not change throughout the entire gestational time, from before conception to after death, regardless of any constitutional or environmental changes.[2] According to the literature, dermatoglyphic patterns are helpful in identifying genetically inherited conditions, such as leukemia, diabetes, syndromes, schizophrenia, hypertension, epilepsy, and cleft lip and palate.[3,4] Not all lesions and conditions have a high likelihood of developing into cancer according to the definition of “potentially malignant disorders.” These oral mucosal conditions are not only site-specific predictors but also markers of the risk of anticipated future cancers elsewhere in the oral mucosa.[5] Leukoplakia and oral submucous fibrosis (OSMF), lichen planus, discoid lupus erythematosus, palatal lesions in reverse smokers, actinic keratosis, sideropenic dysphagia, and chronic hyperplastic candidiasis are a few harmful potentially malignant disorders, which only occur in a small percentage of those exposed to tobacco or betel nut use, and are causally linked to these habits, according to a variety of epidemiological and experimental findings. The susceptibility of this individual would be explained by genetic differences.[6,7]

To be used as a screening in the initial diagnosis of smokeless tobacco use, early detection is absolutely necessary. Early intervention techniques, including counseling, dietary changes, and behavioral therapy, may greatly reduce morbidity and mortality. According to the adage, prevention is always preferable to treatment, and this new field of scientific study will help in forecasting numerous diseases and their repercussions. This study evaluated the dermatoglyphic patterns of smokeless tobacco users to evaluate the variations in the patterns and determine the usefulness of dermatoglyphics in determining the genetic etiology.

MATERIALS AND METHODS

In 2021-2022, a case–control research was conducted. Randomly chosen participants showed up at the outpatient department (OPD) of the Narsinhbhai Patel Dental College and Hospital in Visnagar, Gujarat. A sample size of 500 was used, consisting of 500 individuals (250 cases and 250 controls), with a confidence interval of 95% and a power of 90%. Subjects between the ages of 18 and 60 had a history of using tobacco-free form only, after obtaining written informed consent. Subjects in the control group, who were age and sex matched throughout two years, did not currently or in the past consume alcohol or cigarettes. Patients who may have had lesions that covered the palm crease as a result of trauma or exfoliation were not included in the study. The probe was approved by the institutional ethical committee before it began. The hands were completely washed, and the dermatoglyphic patterns were collected with the ink technique. All study subjects had duplicate ink applied to their distal phalanges. The rolling impression method was used to acquire the fingerprint prints on white, A4-sized blank paper. Data were collected to look for different dermatoglyphic patterns. The “ATD” angle is computed. The data were then examined for both qualitative and quantitative analyses in Statistical Package for the Social Sciences (SPSS).

RESULTS

This study comprises a total of 250 cases and 250 controls. The average “ATD” angle was found to be higher in cases than controls both in males and females and both on the right and left sides as the value is more than 0.001 [Table 1]. Whorls were found to be higher in controls than in cases in both genders. Loops were found to be higher in cases than in controls in both groups [Table 2].

Table 1.

Gender comparison of “ATD” angle among cases and control groups using Student’s t-test

Gender	ATD angle (palm)	Case Mean±SD		Control Mean±SD		P
Male	Right	35.27	0.887	37.56	1.162	(<0.001)
	Left	35.21	0.903	37.72	1.019	(<0.001)
Female	Right	37.135	1.483	42.483	1.892	(<0.001)
	Left	37.25	1.178	42.48	1.626	<(0.001)

Table 2.

Gender comparison of qualitative parameters of cases with respective control using the Chi-square test

Gender	Patterns	% of patterns within group		P
		Cases % (n)	Controls % (n)
Male	Whorls	58.9% (294)	60.2% (301)	(0.020)
	Loops	38.5% (193)	23.2% (116)	(<0.001)
	Arches	4.3% (22)	7.3% (37)	(0.010)
Female	Whorls	57.9% (290)	61.1% (305)	(0.087)
Loops	34.5% (173)	29.2% (146)	(0.217)
Arches	5.6% (28)	5.9% (30)	(0.412)

DISCUSSION

In the present study, we found that the mean “ATD” angle was higher in cases than in controls, which is statistically significant. The mean ATD angle was found to be statistically significantly higher in controls than in patients with OSMF and cancer patients in a study conducted by Vijayaraghavan A et al.[8] Similar findings were noted by Shukla Devashree et al. who reported more ATD angle in control patients than in patients with OSMF and leukoplakia.[9] Similar findings were noted by Goutham Gandham et al. too in their study conducted in which the ATD angle was less in cases of habit of tobacco consumption and alcohol consumption than in controls.[10] Whorls were found to be higher in controls than in cases in both genders. Loops were found to be higher in cases than in controls in both groups in the current study. The whorl pattern was found more in control patients than in patients with OSMF and in patients with oral cancer in a study conducted by Athreya Vijayaraghavan et al.[8] A significant increase in the percentage of loops among gutkha chewers with OSMF and an increase in the whorl patterns among the control group were noted in a study conducted by Munishwar Parvathi Devi et al. in 2015.[11]

CONCLUSION

In summary, it has been determined that smokeless tobacco addicts’ dermatoglyphic patterns differ significantly in statistical terms from those of the general population in both the qualitative and quantitative dimensions. The findings of this investigation show a correlation between a few palmer patterns and smokeless tobacco abuse, suggesting that dermatoglyphics may be a useful anatomical, noninvasive, and cost-effective screening tool for high-risk populations that enable early management. This work provides insight and offers a new perspective on the role of inheritance, which calls for additional study in this area. The difference might be accounted for by the genetic variations that exist among the several groups that were the focus of this investigation. For populations who are more prone to alcohol and tobacco consumption, these dermatoglyphic traits can be used as a screening tool.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.