LETTER
The Pemberton and Maroni Signs
Paul G. Auwaerter, MD
1 June 1997 | Volume 126 Issue 11 | Page 916
TO THE EDITOR:
Drs. Wallace and Siminoski [1] have written a wonderful case report on the usefulness of the Pemberton sign as a physical diagnostic maneuver for detecting substernal goiter. The accompanying dramatic color photographs will no doubt leave readers with an indelible image. However, an additional uncommon physical finding can be seen in the photograph of the patient with his arms in the downward position. The erythema of the skin directly overlying the thyroid gland is termed the Maroni sign and is found in patients with hyperthyroidism [2]. The erythema is often seen in the discrete contour of the thyroid gland and may be associated with pruritus. Therefore, this patient with a suppressed thyroid-stimulating hormone level may have been given a diagnosis of hyperthyroidism and substernal goiter on the basis of clinical examination without any additional studies.
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Author and Article Information
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Johns Hopkins University School of Medicine, Lutherville, MD 21093
1. Wallace C, Siminoski K. The Pemberton sign. Ann Intern Med. 1996; 125:568-9.
2. Sapira JD. The Art and Science of Bedside Diagnosis. Baltimore: Williams & Wilkins; 1990:231.
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