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LETTER
The Pemberton and Maroni Signs
Catherine Quiddam Norcross, RN;
William A. Norcross, MD; and
Theodore G. Ganiats, MD
1 June 1997 | Volume 126 Issue 11 | Pages 915-916
TO THE EDITOR:
In their article on the Pemberton sign, Wallace and Siminoski [1] provide two photographs to illustrate the phenomenon of facial suffusion after elevation of the arms in a patient with a large substernal goiter. In comparing the two photographs (showing the patient before and after the arms were elevated), we are puzzled. First, in the "before" photograph, the chest is tanned, but in the "after" photograph, it is almost white. Second, the background, indeed the entire image, is darker than in the "after" photograph. Third, and most vexing, is that in the "after" photograph, the line of demarcation of the facial and neck suffusion at the base of the neck is perfectly curvilinear. We would be interested to hear the authors' explanation of these perplexing observations.
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Author and Article Information
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Spring Valley, CA 91977
University of California, San Diego, Medical Center, San Diego, CA 92103
1. Wallace C, Siminoski K. The Pemberton sign. Ann Intern Med. 1996; 125:568-9.
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