5 December 1970
Fingerprint Changes in Coeliac Disease
T. J. DAVID,* M.B., CH.B.; A. B. AJDUKIEWICZ,t M.B., B.SC., M.R.C.P.; A. E. READt M.D., F.R.C.P.
British MedicalJournal, 1970, 4, 594-596
Summary: Study of the fingerprints of 73 patients with
varying between moderate epidermal ridge atrophy and
actual loss of fingerprint patterns. Of the patients 63 had
these abnormalities, compared with 3 out of 485 controls.
A high degree of correlation existed between ridge atro-
phy and changes in the clinical state of patients with
It is well appreciated that certain diseases affect the condi-
tion and clarity of fingerprints. These include eczema, leprosy,
nigricans (Verbov, 1970), scleroderma (Chatterjee, 1967), and
Darier's disease and skin lesions due to radiation (Cherrill,
1950). Extremes of age also affect the clarity of fingerprints.
During a survey of hospital inpatients unexpected abnormali-
ties were detected in patients with coeliac disease.
Methods and Subjects
Rolled and plain impressions of fingerprints were taken as
directed by the Home Office (1960), after full explanation had
been made to the patients. Ether was used in every case to
obtained by lifting latent impressions from glazed white tiles
as described by the Federal Bureau of Investigation (1963),
using "Bristol black" powder and standard lifting materials.§
were retaken on each visit
department. One to eight sets of fingerprints were obtained
from each patient over a period of two years. All prints were
taken by the same person (T.J.D.).
Patients with Coeliac Disease.-Every patient had been fully
disease. All of them had had a jejunal biopsy which showed
subtotal villous atrophy. The average age of the 73 patients
(25 males and 48 females) studied was 35 years;
under 15 years of age.
Controls.-These consisted of 275 healthy women (hospital
medical staff), 45 healthy men (hospital medical staff),
male inpatients, 85 female inpatients, 5 hospital domestic staff
(not using gloves for washing-up), and 40 patients who had
lost weight (those who had lost 1 to 8 st. (6.4 to 51 kg.) due to
to the outpatient
Of the 73 subjects, 63 had abnormal fingerprints-21 men
(10 on gluten-free diet) and 42 women (31 on gluten-free
diet). Ten patients had normal prints-four males (three on
gluten-free diet) and six females (five on gluten-free diet)-
seven were children. The abnormalities found were as follows:
(1) ridge atrophy, with the appearance of white lines (see
below), and (2) further ridge atrophy, with
ridges and disappearance of white lines.
loss of visible
Avenue, Chicago, Illinois 60640, United States of America.
* House Physician, Department of Medicine,
Bristol BS2 8HW.
Registrar, Department of Medicine,
tProfessor ofMedicine, Universityof Bristol.
theInstitute of Applied Science,
Bristol Royal Infirmary,
In five patients their fingerprints improved when they were
improvement when treated with a gluten-free diet, one of
these having had no clinical improvement either. In two other
patients who relaxed their gluten-free diet their fingerprints
deteriorated (in the reverse of the sequence above); this cor-
responded with a clinical deterioration. The fingerprints of
eight patients deteriorated when they relapsed while still on a
gluten-free diet; in one case these changes occurred 10 days
already on a gluten-free diet showed improvement of their
fingerprints when their clinical condition improved, and in
two of these only after corticosteroids had been given.
Only three controls had the same changes as those found in
the patients with coeliac disease. Of these, two had primary
patients with these two diseases had normal fingerprints. All
the domestic staff had abnormal prints, but the changes were
different from those in patients with coeliac disease, and
consisted of irregular breaks and cracks in the ridges with
white lines but no ridge atrophy.
a gluten-free diet and in two there was no
The changes in coeliac disease (Figs.
(a) Eczema (Fig. 4): Some fingers may be normal and others
affected. In one fingerprint some parts of the pattern may be nor-
mal and other parts completely obscured. The patchiness of the
changes in eczema makes it easily differentiated from ridge atro-
phy, though in a very bad case the fingerprint patterns may be
completely obscured, in which case the disease should be clinically
(b) Trauma: Usually localized to one or two digits, and is com-
monest on the left forefinger (Cherrill, 1954,
cuts leave quite characteristic scars, as do certain occupations such
as carpentry and tailoring (Galton, 1965).
(c) Skin grafts: Individual digits affected only.
(d) Severe mental subnormality: As
nounced ridge atrophy should be self-evident.
(e) Dotted ridges (Fig. 5): Found in Darier's disease; extremely
rare in normal people.
(f) Warts: Easily visible to the naked eye.
(g) Ridge dissociation (Fig. 6): Also wrongly called dysplasia.
Excessively rare and quite distinctive. Thumb most affected of all
fingers in ridge dissociation, whereas little finger worst affected in
patients with coeliac disease.
(h) Early infancy, old age: White lines are normally present. In
old age the skin becomes dry and the ridges appear less distinct.
(i) Denervated hand:
This obscures inked prints and
(k) Ridge aplasia: Complete absence of fingerprints. Very rare,
and found mainly in Japan and the United States of America;
inherited as a Mendelian dominant (Cummins, 1970).
to 3) are distin-
p. 98). Burns and
a cause of occasional
In this preliminary survey 86% of 73 patients with coeliac
disease had ridge atrophy of their fingerprints. If the adults
are taken alone then 95 % have ridge atrophy. The number of
children studied is insufficient to ascertain whether untreated
coeliac disease affects their fingerprints, since 10 of the 12