Which statement about the presence of a single palmar crease is true?

• A. Short fingers, incurved little finger, and low-set thumb
• B. Flat facial profile
• C. Epicanthal folds
• D. It is suggestive of Down syndrome only when accompanied by other dysmorphic features

Answer: (D)

A single transverse palmar crease is a non-specific finding. It can appear in healthy individuals and in various conditions, not just Down syndrome. While it’s more common in Down syndrome, it does not by itself confirm the diagnosis. Therefore, the statement that it is suggestive of Down syndrome only when accompanied by other dysmorphic features is the best way to describe its role: the crease can raise suspicion, but a diagnosis should rely on the overall pattern of features and confirmatory testing. When other characteristic signs—such as facial features commonly associated with Down syndrome—are present in addition to the single palmar crease, the likelihood increases and appropriate genetic testing is pursued.