We read with interest, and unease, the letter by Dr. Schrander-Stumpel [1998] on the importance of using terminology that is least offensive to the patients and families involved, and took notice that for this reason Dr. Schrander-Stumpel and others in Europe and the USA do not use the term Kabuki "make-up" syndrome but say Kabuki (or Niikawa-Kuroki) syndrome. The comment called to mind our debate during the preparation and revision of the manuscript that reported the syndrome [Niikawa et al., 1981]. We initially used the term "Kabuki actor syndrome," but changed to "Kabuki make-up syndrome" in the published version, because the latter is more to the point and because it is less offensive to the Kabuki actors. Kabuki is a traditional Japanese drama, which is very much alive today. We discussed but quickly discarded "Kabuki syndrome" because the term Kabuki indicates the drama form itself, not the make-up of its actors.
We were chagrined to learn that the term Kabuki "make-up" syndrome is offensive to the patients and families involved, and that Kabuki has joined the rank of Japanese words adopted into English but distorted through the process. In return, we would like to pose a question: Is the term "Kabuki syndrome" not offensive to the people engaged in Kabuki?