Unusual palm creases and unusual children. The Sydney line and "type C" palmar lines and their clinical significance in a child development clinic

Do biometric parameters of the hand differentiate schizophrenia from other psychiatric disorders? A comparative evaluation using three mental health modules

The link between schizophrenia and anomalies in the distal upper limb is well documented. Preliminary studies have identified a number of biometric parameters of the hand by which schizophrenics can be distinguished from matched controls. The current study seeks to determine whether patients with schizophrenia can be singled out from a disparate group of other mental disorders by using the same parameters. We studied three groups, totaling 134 men: 51 diagnosed with schizophrenia, 29 with anxiety and mood disorders, and 54 comprising a control group. Seven parameters were studied: the proximal interphalangeal joint, the eponychia of the middle and ring digits, two dermatoglyphic features, and two constitutional factors. Examiners evaluated the parameters based on photographs and prints. An initial Mann Whitney comparison showed no significant difference between the control group and those identified with anxiety and mood disorders. We therefore accounted for them as a single group. In a discriminant analysis, an overall accuracy of 78.4% was established with a sensitivity of 80.4% (schizophrenics identified correctly) and a specificity of 77.1% (controls identified correctly). These results suggest that the biometric parameters employed may be useful in identifying patients with schizophrenia from a disparate group of other mental disorders.

The hand as a target organ in child abuse

The authors reviewed the abuse reports submitted by the staff of The Children's Hospital, Columbus, Ohio, to determine the incidence and types of injuries inflicted to children's hands. The authors did not study hand injuries in children who were not reported as physically abused. The authors examined two time periods to ascertain changes injury severity. Of the 631 abuse reports submitted from 1980 to 1982, there were 52 injuries (8.2%) involving the hands. From July 1987 to July 1988 there were 42 hand injuries (13.4%) among 313 reports. In the 94 total cases, 19 (2%) children sustained injury to the hand only, including eight with burns, two with bruises, two with human bites, two with erythema, two with fractures, and one with a laceration. Children with burns to the hand alone were significantly younger than those with other types of injuries. Of the 94 children with hand and other injuries, 18 (20%) required hospital admission. Of the 19 with injuries to the hand only, five required hospital admission. A variety of instruments were used to injure these children. The hand is a delicate organ, and it is frequently the primary or incidental target of child abuse. Familiarity with the patterns and types of hand injury suffered in child abuse is essential for early recognition, reporting, and child protection.

Dermatoglyphics in von Recklinghausen neurofibromatosis

We studied dermatoglyphic traits in 27 patients (12 males and 15 females) with neurofibromatosis type I (NF-1) to verify which characteristics may be considered typical of this disorder. The frequency of digital central pockets in the patients was significantly greater than in control individuals (P less than .005), but when we evaluated the sexes separately, the difference was significant only among females (P less than .002). The distribution of central pockets on the various fingers was significantly different in affected females, compared with normal controls, but only on fingers II (P less than .05), IV (P .002), and V (P less than .05). The quantitative finger tip pattern values and the total finger ridge count (TFRC) were always higher in the patients, as well as was the a-b ridge count. The latter was significantly increased only on the right hand in females (P less than .01). Among the patients, the atd angle values were increased on both hands of females and on the right hand in males, whereas both the ulnar index A'-d and the a-t' ridge counts were diminished. The frequency of high endings (5' or 5") of line A was increased in NF-1 patients on both hands. Like in previous investigations, our patients showed an increased number of secondary creases, limited to II degree according to Vormittag et al. [1986] (P less than .048). Our results only partially confirmed prior data. Therefore, we think that there is no typical dermatoglyphic pattern in NF-1 and that this parameter is not a diagnostic indicator in this disorder.

Development of human palmar and digital flexion creases

To determine the timing of the development of the various palmar and digital creases, we examined the hands of 100 human fetuses obtained after therapeutic abortion. The fetuses ranged in age from 7 to 19 fetal weeks, with age being established by menstrual period dates and ultrasound examination before termination. Our observations show that palmar and digital creases develop between 8 and 13 fetal weeks. Digital creases are well defined by 10 weeks; palmar creases are consistently seen by 13 weeks of gestation. The volar pads are present from 8 to 14 fetal weeks. A hand malformation or specific insult that occurs before the time of crease development and that alters the form or function of the fetal hand can cause secondary alterations increase patterns of the hand.

Changes in the Sydney line during the first year of life

Ninety-seven healthy newborns with a Sydney line in 143 palms were re-examined between the ages of 10 and 14 months. The Sydney line was no longer present at follow-up in 58.8 per cent of these infants and in 66.4 per cent of the palms. It appears that the Sydney line, unlike the simian line and its variants, is age-dependent and is not a permanent structure of early intrauterine origin.

The Sydney line and the simian line: the incidence in Down's syndrome patients with mental retardation and Japanese controls

The frequencies of the Sydney line and the simian line on the palms of 694 normal Japanese subjects (500 males and 194 females), 180 with Down's syndrome (113 males and 67 females) and 107 with mental retardation (62 males and 45 females) were studied and the following conclusions were obtained: the frequency of the Sydney line tends to be lower in normal Japanese controls than in Australian and North American controls, and the simian line tends to be higher in normal Japanese controls than in Australian and North American controls. Of these two palmar creases, the simian line is more useful in identification of Down's syndrome patients than is the Sydney line in the Japanese population.

A dermatoglyphic study of autistic patients

Dermatolglyphic patterns of autistic children were compared to those of control subjects matched socioeconomically and by age and sex. Analysis of dermal ridge patterns and ridge counts resulted in significant differences between the 78 autistic and 78 normal children. Differences from normal expectation in the autistic children were most apparent in the reduced number of whorls and increased number of arches, in lowered ridge counts, and in less distinctness in formation of ridge line. The number of dermal ridges on autistic hands was much lower for each finger as well as for the total hand. Moreover, covariance of the contribution of increased numbers of arches failed to alter the significance of findings of general reduction of ridge count in the autistic sample. Other abnormalities of ridge structure among the autistics were noted and described. Complete absence of transverse crease in this sample was combined with other dermatoglyphic evidence to argue for the separateness of autism from other pathological syndromes. It was concluded that evidence was sufficient to indicate the existence of congenital factors in the etiology of autism.