Adermatoglyphia: Challenges and Prospects in Diagnosis

Asian Journal of Research in Dermatological Science

3(1): 30-39, 2020; Article no.AJRDES.57731

A. Aladeh Dieprebi1, D. Altraide Dasetima1*, Otike-Odibi Bolaji1 and Abbey Belema1

1Dermatology Unit, Department of Internal Medicine, University of Port-Harcourt Teaching Hospital, Alakahia, Rivers State, Nigeria.

Authors’ contributions

This work was carried out in collaboration among all authors. All authors did Literature research. All authors read and approved the final manuscript.

Article Information

Editor(s): (1) Dr. Giuseppe Murdaca, University of Genova, Italy. Reviewers: (1) Fábio André Castilha, Rio De Janeiro Federal University, Brazil. (2) Osvaldo A. Cuello Videla P, CIUDA, Universidad del Aconcagua, Argentina. (3) Nilesh Rakate, Berhampur University, India. Complete Peer review History: http://www.sdiarticle4.com/review-history/57731

Received 20 March 2020 Accepted 27 May 2020 Review Article Published 17 June 2020

ABSTRACT

Biometric methods are increasingly being used all over the world for individual identification and authentication. Most methods are complex, however, the use of fingerprints are less complex, cheaper, readily available and thus widely used compared to other modalities. There are three basic fingerprint patterns which are the arches, loops and whorls. The availability of fingerprinting has exposed more cases of adermatoglyphia which is clinically defined as the loss of fingerprints. It can be congenital or acquired, reversible or irreversible. Diagnosis of mostly the congenital forms will require molecular genetic analysis which may be difficult to access in this part of the world and volar pad biopsy which individuals may not consent to. The need for alternative modalities of identification should be in place in cases where fingerprinting is an issue. This article will highlight the fingerprint patterns, the prevalence and aetiology of adermatoglyphia. It will also review the challenges faced when diagnosing adermatoglyphia and future prospects which includes other advanced biometric methods for patients.

Keywords: Adermatoglyphia; biometric; fingerprinting; whorls; loops; arches; prospects. ______

*Corresponding author: E-mail: [email protected];

Dieprebi et al.;AJRDES, 3(1): 30-39, 2020; Article no.AJRDES.57731

1. INTRODUCTION galton demonstrated the value of fingerprints for personal identification and their permanence The scientific study of intricate patterns and throughout life [9,11]. Another researcher, jaun fingerprints from palms, fingers, soles and toes is vucetich in 1892 first used fingerprints to identify referred to as dermatoglyphics [1–3]. These criminals in the court room [3]. Dermoglyphics naturally occurring patterns are unique to an was coined by cummins and midlo in 1926, individual and remain unchanged from birth until derma” means skin and “glyphic” means carvings death [2,4,5]. The fingerprints are not even [5]. Baird (1964) described a kindred of irish- similar in monozygotic twins. Fingerprinting american extraction in which 13 of 24 members known as dactylography is the single most widely of three generations showed an absence of utilized method for individual identification and dermal ridges [12]. authentication (i&a) [4,5]. Adermatoglyphia is clinically defined as the congenital or an acquired In 2007, a swiss woman was denied entry into loss of the epidermal ridge pattern [4,6,7]. It can the us because she had no fingerprints [6]. also be complete or partial loss of the epidermal Similar issue was reported in benue state, ridge pattern. It can be reversible or irreversible. nigeria, where a christian pilgrim was denied the It is also referred to as “immigration delay e-passport by the nigerian immigration [13]. disease” [5,6,8]. Over the past 50 years, a lot of work has been

done on various aspects of dermatoglyphics and Patients with this condition are faced with developmental disorders. Most patients with difficulties when undergoing biometrics and this chromosomal disorders like down syndrome, can be burdensome and depressing for patients edward syndrome, patau syndrome have especially if it is irreversible and moreso as abnormal dermoglyphic patterns [5] alternative methods of identification, authentication and verification are not readily available. 3. EPIDEMIOLOGY OF ADERMATOGLY- PHIA 2. JUSTIFICATION There is dearth of literature on the prevalence of With improving technology, there is need for adermatoglyphia as extensive work has not been biometric analysis which is a means of individual done on the subject. However, the need for identification and authentication based on a set biometrics in identification, authentication and of verifiable means. The use of fingerprint is the forensics application have exposed cases of most commonly used method today. Most adermatoglyphia such that there is increasing patients with adermatoglyphia are unaware of the interest. fact that they cannot produce their fingerprints Haber et al conducted a national survey in and are faced with dismay when biometric lebanon in collaboration with the ministry of analysis fails, moreso as there is little or nothing internal affairs in 2014 which recorded 0.18% that can be done except resorting to other cases of adermatoglyphia with a female modalities of identification. This is also a predominance and an increased incidence in the challenge in other areas such as forensics and aging population with dermatitis as the criminal identification as it slows the process. commonest cause [14].

Diagnosing adermatoglyphia is quite challenging. Two reknowned professors of the university Therefore it is important that a reliable alternative hospital basel, switzerland studied a swiss family to fingerprinting that is cheap, unique and readily with adermatoglyphia and found that nine (9) out available be sought for in the nearest future. of the sixteen(16) members had adermatoglyphia, confirming that the disease has 2.1 Historical Perspective a genetic aetiology [15].

In 1684, a learned and ingenious physician, Loss of fingerprints can be congenital or acquired nehemiah grew, published the first description of [5,6]. The congenital form can be part of a the epidermal ridges which make characteristic complex syndrome and the prevalence will mirror patterns when prints are taken of fingertips [3,9] that of the syndrome. Individuals with completely in 1880, the first paper on fingerprints was missing fingerprints as an isolated finding is published by dr henry faulds expressing it as extremely rare. Four generations were reported important for individualization [10]. In 1890, sir to have this isolated form of adermatoglyphia

Dieprebi et al.;AJRDES, 3(1): 30-39, 2020; Article no.AJRDES.57731

inherited in an autosomal dominant fashion [8], triradius is the meeting place of three systems of [12]. The acquired forms are more common and ridge whose element lies approximately parallel could result from other dermatological conditions to one another at this point. Typically a triradius [5,14,16]. occurs at the base of each digit except the thumb. These are called the digital triradii and At the dermatology unit of the University of Port- are designated a,b,c,d [1–3,17,18]. harcourt Teaching Hospital, Rivers State, Nigeria, there have been three recorded cases of Other landmarks of importance include the core, adermatoglyphia in the past five(5) years the radiants and the delta. A core is the [personal communication]. The most recent approximate center of the palm. In ridge counting being a 21 year old female undergraduate whose the point of core (not the whole core) is used. fingerprints could not be captured during The radiants are ridges that arise from triradius biometric screenings by joint admissions and and enclose the pattern area while the delta is matriculation board, bank verification number the point on a ridge, at or in front of and nearest and national identity card registration at different the centre of divergence of the type lines [1– times. She also found it difficult to use the 3,17,18]. fingerprint application as a means of securing her android phone. Whorl: It is distinguished by concentric design.

4. FINGERPRINT PATTERNS The majority of the ridges make circuits around the core. True whorls typically possess two The fingerprint pattern of the epidermal ridges triradii. There are also composite patterns in form whorls, arches, and loops that are the basis which two or more designs are combined in one for each person's unique fingerprints [3,4] these, pattern area. It contains two or more deltas and like dna are unique to every individual and are is seen in about 25 to 35% of finger print used as means of identification and patterns. There are six types of whorls: authentication. They are unique and difficult to concentric whorl, spiral whorl, mixed whorl, alter making them lifelong markers for central pocket whorl, twin whorl and accidental identification of individuals. whorls [1–3,17,18].

There are three basic fingerprint pattern. Arches: In this pattern, the ridges pass from one  Whorls margin of the digit to the other with a gentle,  Arches distally bowed sweep. It is seen in 5% of  Loop fingerprint pattern. There is no triradius. There are four types of arch patterns: plain arches, The classification of fingerprint pattern is based radial arches, ulnar arches and tented arches [1– on the number of triradii present [2,17]. A 3,17,18].

Fig. 1. Isolated congenital adermatoglyphia in a 21-year-old female undergraduate patient showing fingers of both hands

Dieprebi et al.;AJRDES, 3(1): 30-39, 2020; Article no.AJRDES.57731

Loops: It possesses only one triradius. The patterns are altered in various genetic and non- ridges curve around only one extremity of the genetic conditions. pattern and forms the head of the loop. From the opposite extremity of the pattern, ridges flow to 5. IMPORTANCE OF FINGERPRINTS the margin of the digit, this extremity of the pattern may thus be described as 'open'. Finger print configurations are important According to this, loops may further be of two dermatological landmarks with substantial types, ulnar loop and radial loop. It is seen in applications in medicine, forensics, anthropology, about 60 to 70% of finger prints [1–3,17,18]. and security [3,4,18,21]. The epidermal ridges usually develop around 10 to 17 weeks post- Dermatoglyphics is not limited to fingerprints fertilization, and their formation is influenced by alone as epidermal ridge patterns can also be genetic and environmental components [3,9,22]. seen on the palms, toes and soles. Palmar print These patterns when formed are not configurations include thenar area, hypothenar altered except skin is damaged to the depth of area, interdigital area, palmar creases, a-b ridge 1mm. count and the atd angle. In analyzing finger and palmar prints, other patterns of importance The epidermal ridges are important for grasping include the total finger ridge count, the absolute and to prevent slippage. This explains why an ridge count, the position of the axial triradii and individual with adermatoglyphia have diffficulties the total number of palmar triradii [18–20] these with fine pincer grasp.

Fig. 2. Magnifying glass image of the three fingerprint patterns: whorls, arch and loop

Fig. 3. Magnifying glass image of the left thumb of a 21-year old female with adermatoglyphia

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Dermatoglyphic analysis has been used in aiding absence of teeth, reduced palmar the diagnosis of some disease conditions demoglyphics and hyperkeratosis of palms especially those with strong hereditary basis and and sole. is employed as a method for screening for  Dermatopathia pigmentosa reticularis: anomalies or chromosomal aberrations where Autosomal dominant ectodermal dysplasia unusual patterns have been shown to correlate characterized by a triad of generalized with some genetic disorders. It has also been reticulate hyperpigmentation, non cicatrical used in clinical conditions in which neither a alopecia and onychodystrophy. Patients also single gene nor a chromosomal basis have been have adermatoglyphia, thin brittle nails and discovered. Dermatoglyphics is an important tool lack of sweat glands.this disease is due to in diagnosing physiological, medical, forensic keratin 14 mutation. and genetic conditions and is emerging as a  Reticulate acropigmentation of kitamura: clinical instrument and genetic tool of Autosomal dominant disorder associated significance. with mutations in disintegrin and adam 10 gene. This condition consists of linear palmar The uniqueness of fingerprints are also important pits and pigmented macules 1 to 4 mm in in identifying dead patients in blast injuries, diameter on volar and dorsal part of the accidental exchange of newborn babies, hands and feet. impersonation and paternity issues.  Rothmund thomas syndrome: This is an autosomal recessive poikiloderma Fingerprint biometric are used for identification characterized by sparse hair, eye lashes and during banking transactions, national registration, eyebrows, slow growth small statue, immigration, forensics, building and door access, abnormal teeth, nails and gi problems in phone access etcetera. infancy.

6. CONGENITAL AND ACQUIRED Genes associated with these congenital causes CAUSES OF ADERMATOGLYPHIA includes:

Absence of fingerprints can be congenital or Smarcad 1 gene: swi/snf- related matrix acquired [5]. The congenital cause includes the associated actin-dependent regulator of isolated congenital adermatoglyphia and chromatin sub-family a containing dead/h box 1. adermatoglyphia as part of syndromic manifestation of congenital diseases. The krt 14: keratin 14 isolated congenital form is said to be an dkc1: dyskeratin pseudouridine synthase autosomal dominant condition linked to a wrn: (werner syndrome helicase) wrn recq like mutation of the smarcad1 gene [4,6,23]. helicase blm: (bloom syndrome protein) blm recq like These congenital diseases mostly due to helicase ectodermal dysplasias include basan syndrome, naegeli-franceschetti-jadassohn syndrome, Acquired Causes Can Be Grouped Into dermatopathia pigmentosa reticularis, reticulate Dermatological And Non-Dermatological Causes acropigmentation of kitamura and rothmund [5,14,26]. thomas syndrome [5,7,24,25]. 7. METHODS OF ANALYZING  Basans syndrome: Autosomal dominant FINGERPRINTS ectodermal dysplasia characterized by rapidly healing congenital acral bullae, There are various methods of finger printing. congenital milia and lack of fingerprints. These include: Other features seen in this condition include hypohidrosis, palmoplantar keratoderma,  Transparent adhesive tape method: Dry and nail dystrophy. A mutation in the colouring pigments like chalk, ink or graphite smarcad1 gene was recently reported to are applied on hands. cause basan syndrome.  Photographic method: Polaroid camera is  Naegeli-franceschetti-jadassohn syndrome: used to capture the magnified image Autosomal dominant form of ectodermal  Numerical method: Algorithm of synthesis of dysplasia due to keratin 14 mutation, images of fingerprints is used to create all characterized by reticular skin pigmentation, possible arrangements of ridges called diminished function of the sweat glands, minutiae.

Dieprebi et al.;AJRDES, 3(1): 30-39, 2020; Article no.AJRDES.57731

 Faurot inkless method: commercially investigations are not readily available and as available patented solution is used to record such poses a grave setback at arriving prints on sensitized paper. at a definitive diagnosis. Other investigative  Biometrics method: automatic separate modalities like volar pad biopsy are usually machines for finger and palm scan the hand declined by patients as they see the absence of to record prints. finger prints as a variant of normal and will resist  Inkpad method: the fingers are pressed on attempts for invasive procedures. Another the stamp pad turn by turn and recorded on challenge is tracing of family members to paper. ascertain whether they also have adermatoglyphia. 8. CHALLENGES Paucity of data on adermatoglyphia is also an Diagnosing adermatoglyphia in Nigeria is quite issue as most patients with the condition do not challenging. Patients usually present with present to a health care facility except when in difficulty in capturing fingerprint during need of a medical report. Patients are biometrics. Further evaluation to enable the usually seen during biometrics in the banks, attending physicians get a specific cause is borders or immigration offices and access to halted by lack of molecular genetic testing. This these data are met with some bureaucracies .the is the primary investigation to ascertain whether psychosocial impact patients with the patient has smarcad 1gene and keratin 14 adermatoglyphia face during biometric screening mutation which are the major gene is also enough trauma to make them avoid mutations seen in adermatoglyphia [8,24]. These further analysis.

Fig. 4. (Culled from wikipedia): The congenital form of adermatoglyphia inherited in an autosomal dominant fashion

Table 1. Congenital causes of adermatoglyphia and their associated genes

S/no Disease condition Associated gene 1 Basans syndrome Smarcad1 2 Naegeli-franceschetti-jadassohn syndrome Krt14 3 Dermatopathia pigmentosa reticularis Krt14 4 Reticulate acropigmentation of kitamura Krt14, dkc1 5 Rothmund thomas syndrome Wrn, blm 6 Dyschromatosis universalis hereditaria Smarcad1, dkc1

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Table 2. Dermatological and non dermatological causes of acquired adermatoglyphia

Dermatological Non- dermatological Allergic and irritant contact dermatitis Trauma Atopic dermatitis Burns Dyshidrotic eczema Amputations Cutaneous le Caustic abrasions Epidermolysis bullosa Denervation injuries Pemphigus vulgaris Capecitabine chemotherapy Psoriasis Topical steroids Keratoderma Retapumulin blennorrhagica Atovastatin Palmar warts, Leprosy Pyoderma/impetigo Coxsackie a Tinea mannum Erythema multiforme Steven johnson syndrome Toxic epidermal necrolysis Serum sickness Primary hyperhidrosis Lichen Acrodermatitis

A major setback with the acquired forms of for data collection, biometric assessment and adermatoglyphia is the fact that the patients verification. It can be deployed for use for a large come to clinic with other dermatological and non- number of individuals as it is less complex dermatological complaints and pay little or no compared to other modalities. In patients attention to the absence of fingerprints as it is not with adermatoglyphia, alternative biometric a primary challenge. This makes the attending modalities should be in place as options for physician miss out on acquired causes in the verification. hospitals. These advanced detection modalities play an 9. PROSPECTS important role in applications like video surveillance, border control, to identify shoplifters Advancing technology has made biometric in stores, criminals and terrorists in urban areas, analysis of individuals a common trend. eliminating voter fraud, computer security Dermatoglyphics is a commonly utilized method etcetera.

Fig. 5. Inkpad print of different fingerprint patterns: loop, whorl and arch

Dieprebi et al.;AJRDES, 3(1): 30-39, 2020; Article no.AJRDES.57731

Fig. 6. Inkpad right thumb print of the 21-year-old female patient with adermatoglyphia. Note the absence of epidermal ridge configuration

The Nigerian immigration service use wall of the eyeball while iris scanning utilizes a photographic image of the face and palm plus camera mounted somewhere between three and fingers with a valid doctors’ report as a means of ten feet away from an individual to snap a high identifying individuals with adermatoglyphia. definition photograph of eyes of the person. It then interprets >200 different points [21,28,30]. Back up biometric methods should be unique, readily available, generally acceptable, Electronic signature and keystroke dynamics: universally present, with unchanging and Electronic signature makes a trace on an quantifiable results throughout the lifespan of the electronic screen or device which has software individual [21,27,28]. These characteristics make that associates a series of biometric data it difficult to choose a particular alternative. (pressure, strokes, the speed of writing, etc.) To Available biometric methods that can be used as the identity of the signer while keystroke back up for patients with adermatoglyphia dynamics technology records dwell time (which is include physiological subtypes (face recognition, the length of time a person holds down each palm print, hand geometry, iris and retinal scan), key) as well as flight time (which is the time it and behavioral subtypes (signatures, keystroke, takes to move between keys) [21,28,30]. and voice and gait patterns) [5,21,28-30]. Other high-tech biometric parameters that have Face recognition uses a system where computer been studied include finger vein pattern, tongue application automatically identifies a person from printing, electrocardiography and radio-frequency a digital image or a video source without contact identification technology [21,30]. or touching. It identifies subjects based on their facial characteristics like distance between 10. CONCLUSION cheekbones and eye socket position [28,31]. More cases of adermatoglyphia are being seen Palm print recognition and hand geometry: because of the increased need for individual palmprint recognition involves identifying identification and authentication using biometric individuals based on lines and creases on the methods in countries around the world and palm of the hand, the aggregate of information Nigeria in particular. The psychosocial impact of presented in a friction ridge impression and then this condition cannot be overemphasized. With extract the minute detail [28–30]. Hand geometry advancing technology, other biometric modalities utilizes more than 90 dimensional should be made readily available, universally measurements to record an accurate spatial acceptable and have the ability to be easily representation of the hand of a person [28]. reproduced when the individual is called upon. These standardized alternative modalities of Iris and retinal scan: retinal scanning is electronic identification should be in place in cases where scanning of the retina, the innermost layer of the fingerprinting is an issue.

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