Down Syndrome Facies (b)

I see (W. Wertelecki, M.D.) a facies of Down syndrome (DS). The facies is a facial syndrome (concurrence of characteristic signs – epicanthic folds, upward slant of palpebral fissures, small round ears, flat nasal bridge and short nose with a small tip, etc.). However, facies are more than the sum of dysmorphic signs, in this case, epicanthic folds and a small nose. What “I see” is more than just two dysmorphic signs – my brain tells me that the proportions of this face are also a sign – I cannot explain that in words – just like you recognize your relatives, you will recognize faces of people with DS who are related not as relatives but as having a dysmorphic syndrome in common.