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Exploring Patterns of Palmar Hyperlinearity in Pediatric Population With Atopic Dermatitis or Ichthyosis Vulgaris

Aditi Goyal1, Reshu Gupta2, Riya Singhani1

  • 1Department of Dermatology, RUHS College of Medical Sciences, Jaipur, IND.

Cureus
|March 12, 2026
PubMed

Insights

Palmar hyperlinearity patterns differ between ichthyosis vulgaris (IV) and atopic dermatitis (AD) in children. This finding can aid in early diagnosis and phenotyping of these common skin conditions.

Area of Science:

  • Dermatology
  • Genetics
  • Pediatrics

Background:

  • Ichthyosis vulgaris (IV) and atopic dermatitis (AD) are common pediatric skin diseases impacting quality of life.
  • Palmar hyperlinearity is a recognized indicator of skin barrier dysfunction in IV and AD.

Purpose of the Study:

  • To investigate and differentiate patterns of palmar hyperlinearity in children diagnosed with IV, AD, or both.
  • To assess the diagnostic and phenotyping utility of palmar hyperlinearity in pediatric skin disorders.

Main Methods:

  • A cross-sectional study involving 206 children (6 months to 18 years) with confirmed IV, AD, or co-diagnosis.
  • Assessment of five pre-defined palmar patterns, categorized as hyperlinear or non-hyperlinear.
  • Evaluation of inter-rater reliability using the Fleiss Kappa statistic.

Main Results:

  • 58.7% of participants exhibited hyperlinear palmar patterns.
  • Frequent cross-hatch patterns were associated with isolated AD.
  • Thick perpendicular lines were prevalent in IV-only cases, while diamond patterns indicated co-occurring AD and IV.
  • Classification showed substantial inter-observer agreement (Kappa = 0.62).

Conclusions:

  • Distinct palmar hyperlinearity patterns exist for IV and AD in children.
  • Palmar pattern analysis offers a cost-effective adjunctive method for early diagnosis and phenotyping, especially when genetic testing is unavailable.
Abstract

Keywords:
atopic dermatitisfilaggrinhyperlinear palmsichthyosis vulgarispediatric dermatology

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