Profile of Cheiloscopy in Patient with Melasma: An Observational

Study

Satya Wydya Yenny

, Rahma Ledika Veroci

Department of Dermatology-Venereology, Dr. M. Djamil Hospital, Medical Faculty of Andalas University, Padang, West

Sumatera, Indonesia

Department of Dermatology-Venereology, School of Medicine, Medical Faculty of Andalas University, Padang, West

Sumatera, Indonesia

Keywords: cheiloscopy, melasma.

Abstract: Background: Cheiloscopy is a forensic investigation technique that deals with identification of humans based

on lips traces. Several studies had been conducted to determine the distribution of different lip print pattern

in some clinical condition with genetic influence, such as hypertention and the inheritance of cleft lip and

palate. Melasma is one of skin disease which is also genetically affected. This study was aimed to find out

cheiloscopy and its pattern in patients with melasma compared with control. Methods: The study compared

lip print pattern between 30 individuals with melasma and 30 healthy controls. Lip prints were collected using

cellophane tape and recorded in white chart paper. All four quadrant of lip were observed. Results: Type IV

of lip prints dominated all four quadrants in individuals with melasma. From healthy controls, type I was

predominant in three quadrants of lip. Conclusion: The result from the present study indicates a significant

association between lip print pattern and melasma. Therefore, it may be possible to predict risks of developing

melasma in each person with significant association from lip prints.

1 INTRODUCTION

Melasma is a common hypermelanosis that typically

occurs on sun-exposed are in the face. The

appearance of pigment is heightened in the summer

when UV exposure is more common. At least three

clinical patterns have been described: centrofacial

(64%), malar (27%), and mandibular (9%). The

course is typically chronic, fading when UV exposure

is diminished (Lepeere et al, 2012). Onset of melasma

typically occurs in a woman’s childbearing years (20s

through 30s) and in darker skin types, such as

Hispanics, Latinos, Asians, and African-Americans

(Lee, 2014).

Melasma is a common hypermelanosis that

typically occurs on sun-exposed areas in the face. The

pathogenesis is poorly understood, but genetic and

hormonal influences in combination with UV

radiation are important (Lepeere et al, 2012; Lee,

2014). Racial and/or familial predisposition suggests

that genetic factors contribute to the pathogenesis of

melasma. Pigmentary disorders including melasma

are common in Hispanic and Asian racial groups with

Fitzpatrick skin types III/V, although a few

epidemiologic reports are available in different ethnic

groups. Studies from different countries address the

familial occurrence of the disorder. An epidemiologic

study in a tertiary dermatological referral center in

Singapore showed that a positive family history was

observed in 21 (10.2%) of 205 patients with melasma.

A study with 312 patients with melasma in India

reported that 104 patients (33.3%) had a positive

family history. Positive family history, as high as

54.7%, was shown in a study on 400 pregnant women

in Iran. Familial occurrence is as high as 56.3% of 302

patients from Brazil. Although the rate of occurrence

from different countries and even from the same

country shows a wide range of differences, family

history is associated with melasma on epidemiologic

study. However, to date, there is no study about

cheiloscopy in melasma.

Cheiloscopy (quiloscopy) can be defined as a

method of identification of a person based on

characteristic arrangement of lines appearing on the

red part of lips or as a science dealing with lines

appearing on the red part of lips. It is unique to an

individual, except for monozygotic twins. Lip groove

patterns can be identified from the 6th week of

intrauterine life (Peter et al, 2016).

236

Yenny, S. and Veroci, R.

Proﬁle of Cheiloscopy in Patient with Melasma: An Observational Study.

DOI: 10.5220/0008154702360239

In Proceedings of the 23rd Regional Conference of Dermatology (RCD 2018), pages 236-239

ISBN: 978-989-758-494-7

Fischer in 1902 was the first anthropologist to

describe the furrows on the red part of the human lips.

However, it was only in 1932 that Edmond Locard,

one of Franceís greatest criminologists,

recommended the use of lip prints in personal

identification and criminalization. In 1950, Synder

reported in his book Homicide Investigation that the

characteristics of the lips formed by lip grooves are as

individually distinctive as the ridge characteristics of

fingerprints. Suzuki and Tsuchihashi, in 1970,

devised a classification method of lip prints, which is

as follows (Peter et al, 2016; Singh et al, 2017; Mishra

et al, 2009; Prabhu et al, 2012):

1. Type I : a clear-cut groove running vertically

across the lip.

2. Type I’ : partial-length groove of type I

3. Type II : a branched groove

4. Type III: an intersected groove

5. Type IV: a reticular groove

6. Type V : irregular/other pattern

Lip prints are unique and do not change during the

life of a person. It has been verified that lip prints

recover after undergoing alterations like minor

trauma, inflammation

and diseases like herpes. The

form of the furrows does not vary with environmental

factors (Gondivkar et al , 2009). Study shows that lip

print pattern does not change even as age advances.

Besides, cheiloscopy is easier to perform, very

helpful due to its unique pattern and often more

helpful in criminal investigations when other

identification methods or parameters are either not

available or difficult to analyze (Nagrale et al, 2014).

Several studies had been conducted to determine

the distribution of different lip print pattern in some

clinical condition with genetic influence, such as

hypertention and the inheritance of cleft lip and

palate. Melasma is one of skin diseases which is also

genetically affected. This study was carried out to

identify the peculiar lip patterns in patients with

melasma, weather it could be act as predictor for

individuals to get melasma later. As the final goals, it

might be use as preventive methods for melasma as

early as possible.

2 METHODS

A study sample comprised 30 females with melasma

and 30 females without melasma. All samples were

aged between 20 and 55 years. Lips were free from

any pathology, having normal transition zone

between the mucosa and skin were included in the

study. Consent of all the samples was obtained for the

study.

In order to classify the lip prints in this study, the

classification scheme proposed by Suzuki and

Tsuchihashi was used. Materials used were:

1. Red or brown colored lipstick

2. Cellophane tape and scissors

3. White chart paper

4. Magnifying lens

First, lips were cleaned thoroughly. Individuals with

hypersensitivity to lipsticks were not included in the

study. A lipstick was applied with single stroke,

evenly on the vermilion border. The subjects were

asked to rub both lips to spread the applied lipstick.

After two minutes, over the lipstick, the glued portion

of cellophane tape strip was placed and the subject

was asked to make lip impression in normal rest

position of the lips by dabbing it in the center first and

then pressing it uniformly toward the corners of the

lips. The cellophane strip was then stuck to a white

chart paper and then analyzed by using magnifying

lens. The lips were divided into four quadrants; two

quadrants on each lip, and were numbered from Q1-

Q4 in a clock-wise sequence starting from upper

right.

3 RESULTS

The lip print patterns were studied in 30 samples that

clinically diagnosed with melasma, compared with 30

healthy controls. Ethical approval was obtained and

all participants were explained about the purpose of

the study and also the informed consent was obtained

from each of the participant. The study of lip print

pattern of 60 samples including cases and controls

revealed the following observations on Figure 1 and

4 DISCUSSION

Lip prints are very useful in forensic investigation and

personal identification. They are considered to be

most important forms of transfer evidence, and are

analogous to finger prints (Sharma et al, 2009; Telagi

et al, 2011).

In the present study, it was noticed that no two

individuals or more have similar types of lip prints.

Table 1 shows the distribution of lip print patterns

between individuals with melasma and healthy

controls. It revealed that each quadrant (Q) of lips had

a tendency towards a certain type. In 30 healthy

controls, type III was found in 11 (36.67%) samples

in Q1, type I as much 10 (33.33%), 13 (43.33%) also

13 (43.33%) in Q2, Q3 and Q4 respectively.

Proﬁle of Cheiloscopy in Patient with Melasma: An Observational Study

237

Table 1. Distribution of Lip Print Patterns

TYPES

QUADRANT 1 QUADRANT 2 QUADRANT 3 QUADRANT 4

CASES

(n)

CONTROL

(n)

CASES

(n)

CONTROL

(n)

CASES

(n)

CONTROL

(n)

CASES

(n)

CONTROL

(n)

Type I 5 8 4 10 4 13 5 13

Type I’ 3 0 3 0 3 3 3 3

Type II 2 6 3 6 2 1 1 2

Type

III

1 11 3 8 8 8 8 8

Type

19 5 17 6 13 5 13 4

Type V 0 0 0 0 0 0 0 0

TOTA

30 30 30 30 30 30 30 30

Figure 1. Photograph of lip print of patient with melasma

Figure 2. Photograph of lip print of healthy control

RCD 2018 - The 23rd Regional Conference of Dermatology 2018

238

Type I, vertical groove pattern, have a higher

quantity in healthy controls. Vahanwalla and Parekh

(India, 2000) studied lip prints from 50 male and 50

female subjects from Mumbai and found that type I

(branched) was predominant in the lower lip among

the females (Umana et al, 2014).

Otherwise, type IV of lip prints dominated all four

quadrants in individuals with melasma. From the

study of lip prints, 19 (63.33%) samples of type IV

were found in Q1, 17 (56.67%) in Q2, whereas 13

(43.33%) samples in Q3 and Q4. The difference

pattern between cases and healthy controls is

significant. In other words, the research shows a

higher frequency of reticular groove type in melisma

(51.67%) than in healthy control (16.67%). From

literature there has been no research on lip print

pattern of melasma that could be comparison. To our

knowledge, this study is the first study of lip print

pattern in melasma.

5 CONCLUSION

During the past decade, numerous studies addressed

the uniqueness of lip groove patterns and it was

proved that it could be used for personal

identification. The tremendous research done in this

field itself proves its worth as a unique entity (Peter

et al, 2016). Research of lip print patterns in clinical

condition with genetic influence

The result from the present study indicates a

significant association between lip print pattern and

melasma. Therefore, it may be possible to predict

risks of developing melasma in each person with

significant association from lip prints. It can therefore

serve as a non-invasive predictive tool in determining

those people who are at risk of developing melasma

so that clinicians and the general public at large can

be informed and habits that could trigger melasma

can be avoided.

Despite the fact that identification of an individual by

lip prints appears to be accepted in some places, this

procedure requires further studies with larger sample

size. The uniqueness of lip prints pattern in melasma

needs to be more confirmed and accepted.

ACKNOWLEDGMENT

This study was not sponsored and there are no

conflicts of interest.

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