To the Editor:—
I am shocked that your editorial on the reading of Tea Leaves (JAMA192:632 [May 17] 1965) lamentably states that today the physician does not notice the creases of the forehead. It is not true. I do not refer to the raised-forehead effect upon the glabella when the patient is presented with his bill. The absence of furrows resulting from hyperthyroidism is elementary. Those from the leonine facies of leprosy are well known in the tropics. There is the increase in depth and thickness of the skin of the forehead in Touraine-Solente syndrome, pachydermoperiostosis. This remarkable entity is renowned for its cutis vorticis gyrata, which is pathognomonic, sometimes provoking the Freudian eponym of scrotal forehead, when the latter is involved.Please! Tea leaves may be meat for editorialists, but forehead creases are serious medicine.