Down Facies Furrows (Grooves)

Please click to enlarge.

Note what signs you see.

I (W. Wertelecki, M.D.) see a face that is a facies suggestive of Down syndrome (DS). The signs include an upward slant of the palpebral fissures; a relatively small cartilaginous nose and deep facial furrows or grooves. Incidentally, also note the smallness of the teeth (microdontia). In medical parlance, the German word “gestalt” is used to denote an overall form of shape and in this instance the facies is greater than sum of the listed signs.

PERSPECTIVE: One reason to show this image is that the facial furrows may be signals of thickened dermis – such may be related to hypothyroidism, edema and other causes. In fact, DS is associated with prenatal and neonatal edema, hypothyroidism and elevated laxity of connective tissues.