Exploring Patterns of Palmar Hyperlinearity in Pediatric Population With Atopic Dermatitis or Ichthyosis Vulgaris Attending a Tertiary Care Hospital in Jaipur, India

TL;DR

This study explores how palmar hyperlinearity patterns differ in children with atopic dermatitis or ichthyosis vulgaris in India.

Contribution

The study identifies distinct palmar hyperlinearity patterns associated with atopic dermatitis and ichthyosis vulgaris in a pediatric population.

Findings

Hyperlinear patterns were observed in 58.7% of the 206 participants.

Frequent cross-hatch patterns were most common in atopic dermatitis cases.

Thick perpendicular lines were most prevalent in ichthyosis vulgaris-only cases.

Abstract

Introduction: Ichthyosis vulgaris (IV) and atopic dermatitis (AD) are skin diseases occurring in children and having important quality-of-life implications. Palmar hyperlinearity has been characterized as a visible sign of skin barrier abnormality in these disorders.

Methods: In this hospital-based cross-sectional study, children aged six months to 18 years with a confirmed diagnosis of AD, IV, or both were assessed for five pre-defined palmar patterns. Patterns were graded as hyperlinear or non-hyperlinear, and their correlation with disease groups was examined. Inter-rater reliability was evaluated in a subset.

Results: Out of the 206 recruited participants, 121 children (58.7%) had hyperlinear patterns. Frequent cross-hatch was the most common hyperlinear pattern overall, found in relation to isolated AD predominantly. Thick perpendicular lines were most prevalent in IV-only cases, and frequent diamond patterns occurred in children with both AD and IV. Classification was found to have considerable inter-observer agreement (Fleiss Kappa statistic= 0.62).

Conclusions: Patterns of palmar hyperlinearity in AD and IV are different. Detection can be a low-cost adjunct for the early diagnosis and phenotyping, particularly in cases where genetic analysis is not accessible.

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