Single transverse palmar crease

In humans, a single transverse palmar crease is a single crease that extends across the palm of the hand, formed by the fusion of the two palmar creases (known in palmistry as the "heart line" and the "head line"). Although it is found more frequently in persons with several abnormal medical conditions, it is not predictive of any of these conditions since it is also found in perfectly healthy persons. It is found in 1.5% of the world population in at least one hand.[1]

Single transverse palmar crease
Other namesSimian crease, simian line
Single transverse palmar crease on an infant's hand
SpecialtyMedical genetics

Former name

Because it resembles the usual condition of non-human simians, it was, in the past, called the simian crease or simian line. These terms have widely fallen out of favor due to their pejorative connotation.[2]

Medical significance

The presence of a single transverse palmar crease has no medical significance. It is found in 1.5% of all people, and though it is found at a higher frequency in people with abnormal medical conditions, in every one of these conditions many people do not have a single transverse palmer crease, thus it has low predictive value.

Males are twice as likely as females to have this characteristic, and it tends to run in families. In its non-symptomatic form, it is more common among Asians and Native Americans than among other populations, and in some families there is a tendency to inherit the condition unilaterally; that is, on one hand only.

While it is often found in people with Down Syndrome,[3] many who have this syndrome do not have this crease, and thus is not a diagnostic indicator of the Down Syndrome.

The presence of a single transverse palmar has been associated with a number of abnormal medical conditions — that is, it is found at a higher than 1.5% frequency, but in all of these conditions many do not have this crease. Examples of conditions with such an association are fetal alcohol syndrome, and with the genetic chromosomal abnormalities Down syndrome (chromosome 21), cri du chat syndrome (chromosome 5), Klinefelter syndrome, Wolf-Hirschhorn Syndrome, Noonan syndrome (chromosome 12), Patau syndrome (chromosome 13), IDIC 15/Dup15q (chromosome 15), Edward's syndrome (chromosome 18), and Aarskog-Scott syndrome (X-linked recessive), or autosomal recessive disorder, such as Leukocyte adhesion deficiency-2 (LAD2).[4] A unilateral single palmar crease was also reported in a case of chromosome 9 mutation causing Nevoid basal cell carcinoma syndrome and Robinow syndrome.[5] It is also sometimes found on the hand of the affected side of patients with Poland syndrome, and craniosynostosis.

A 1971 study refutes the hypothesis that the phenomenon is caused by fetal hand movement: the appearance of the crease occurs around the second month of gestation, before the digital movement phase in the womb begins.[6]

  • Single transverse palmar crease in an adult
  • More common palmar creases in adults

See also

References
  1. Dar M.D., Hannah (6 August 1976). "Palmar Crease Variants and Their Clinical Significance" (PDF). Medical Encyclopedia. United States National Library of Medicine. Retrieved 20 October 2016.
  2. Cooley, W. Carl; Wilson, Golder (2000). Preventive management of children with congenital anomalies and syndromes. Cambridge, UK: Cambridge University Press. p. 147. ISBN 978-0-521-77673-8.
  3. McPherson M.D., Katrina (3 May 2004). "Simian crease". Medical Encyclopedia. United States National Library of Medicine. Retrieved 28 September 2006.
    - "Definition of Simian crease". MedicineNet. MedicineNet, Inc. 2005. Retrieved 28 September 2006.
    - Hammer, edited by Stephen J. McPhee, Gary D. (2010). "Pathophysiology of Selected Genetic Diseases". Pathophysiology of disease : an introduction to clinical medicine (6th ed.). New York: McGraw-Hill Medical. pp. Chapter 2. ISBN 9780071621670. {{cite book}}: |first= has generic name (help)
  4. Marquardt, Thorsten; Brune, Thomas; Lühn, Kerstin; Zimmer, Klaus-Peter; Körner, Christian; Fabritz, Larissa; Van Der Werft, Natascha; Vormoor, Josef; Freeze, Hudson H.; Louwen, Frank; Biermann, Bettina; Harms, Eric; von Figura, Kurt; Vestweber, Dietmar; Koch, Hans Georg (30 June 1999). "Leukocyte adhesion deficiency II syndrome, a generalized defect in fucose metabolism". The Journal of Pediatrics. 134 (6): 681–8. doi:10.1016/S0022-3476(99)70281-7. PMC 7095022. PMID 10356134.
  5. Olivieri, C.; Maraschio, P.; Caselli, D.; Martini, C.; Beluffi, G.; Maserati, E.; Danesino, C. (February 2003). "Interstitial deletion of chromosome 9, int del(9)(9q22.31-q31.2), including the genes causing multiple basal cell nevus syndrome and Robinow/brachydactyly 1 syndrome". European Journal of Pediatrics. 162 (2): 100–3. doi:10.1007/s00431-002-1116-4. PMID 12548386. S2CID 10565922.
  6. Bali, R. S.; Chaube, Ramesh (July 1971). "On the Formulation of Palmar Creases". Zeitschrift für Morphologie und Anthropologie. 63 (1): 121–130. doi:10.1127/zma/63/1971/121. JSTOR 25755944. S2CID 36961365.

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