In addition to the three composition signs already studied (the capital sign, the number sign, and the letter sign), another composition sign, the italic sign, also known as the emphasis indicator, plays an important role in braille reading. In print, when special typefaces such as italics, boldface, small capital letters, or underlining are used to emphasize or to make distinct a word or passage, these changes must be so indicated in braille. In literary braille, nearly all special typefaces are indicated by the same composition sign, the italic sign (dots 4-6).
Foreign words, titles and proper nouns such as names of ships, subject headings at the beginning of paragraphs, silent thought, and quoted material that is printed in a special typeface all must be distinguished in braille using the italic sign. Sometimes, however, print typeface changes are used merely to make the production more visually appealing, such as when titles are printed in huge letters or script, in which case they are ignored in braille.