Coarse facial features or coarse facies describes a constellation of facial features that are present in many inborn errors of metabolism. Features include: * large, bulging head * prominent scalp veins * "saddle-like, flat bridged nose with broad, fleshy tip" * large lips and tongue * small, widely spaced and/or malformed teeth * hypertrophic alveolar ridges and/or gums Heads tend to be longer than normal from front to back, with a bulging forehead. This is because of the earlier than normal or premature fusion of skull bones in an affected individual.