FACES IN DIFFERENT MEDICAL CONDITIONS

1. Bird facies (Pierre Robin Malformation)

Small lower jaw, a slit like hole in the palate of mouth (called cleft palate) and the tongue appear to fall into the throat (condition called as retroglossoptosis).

2. Chipmunk facies ( Untreated β Thalassemia major, Bullimia nervosa, Parotid swelling)

Expanded globular maxillae, with BM hyperexpansion into facial bones, combined with prominent epicanthal folds.

3. Leonine facies (Lepromatous Leprosy)

Peculiar, deeply furrowed, lionlike appearance of the face.

4. Adenoid facies (Adenoid hypertrophy)

Long, open-mouthed, dumb-looking face of children.

5. Torpid or Myxedematous facies (Myxedema)

Skin generally thickened, alopecia, periorbital oedema, xanthelasma, coolness and dryness of skin and hair, thinning of scalp hair, tongue swelling.

6. Mask like or Parkinsonian facies (Parkinsonism)

Mask-like, tremor of head, absence of blinking, dribbling of saliva, weakness of upward gaze, vacant look, seborrhoea and sweatiness.

7. Acromegalic facies (Acromegaly)

Large supraorbital ridge and frontal bossing, thickened lips, enlarge tongue, lower jaw firm and square (protruding jaw = prognathism).

8. Cushingoid facies (Cushing syndrome)

A rounded face with a double chin, prominent flushed cheeks, and fat deposits in the temporal fossa and cheeks.

9. Gargoyle facies (Hurler syndrome)

Head is large and dolichocephalic, with frontal bossing and prominent sagittal and metopic sutures, with mid-face hypoplasia, depressed nasal bridge, flared nares, and a prominent lower 1⁄3 of face, thickened facies, widely spaced teeth and attenuated dental enamel, gingival hyperplasia.

10. Thyrotoxic facies (Grave’s disease)

Alert, startled, flushed and anxious appearance. Protrusion of of one or both eyes (exopthamlos) associated with retraction of the upper eyelids (lid lag) which results in the exposure of white conjunctiva above the cornea (Von-Graef’s sign).

11. Hatchet facies (Myotonia atrophica)
They have a tented, open mouth, elongated face and blunt affect. This appearance often results from the re-shaping of facial bones in childhood and adolescence due to the progressive pulling and wasting of affected muscles.

12. Flat facies (Down syndrome)

Flat appearing face, small head, flat bridge of the nose, smaller than normal, low-set nose, small mouth which causes the tongue to stick out and to appear overly large, upward slanting eyes, epicanthal fold, rounded cheeks, small misshapen ears.

13. Snarling or Myasthenic facies (Myasthenia gravis)

Drooping of the eyelids and corners of the mouth and weakness of the facial muscles.

14. Mitral facies (Mitral stenosis)

Rosy, flushed cheeks and dilated capillaries.

15. Elfin facies (William’s Syndrome)

Sunken nasal bridge, puffiness around eyes, epicanthal fold, blue starry eyes, long upper lip length, small and widely spaced teeth, small chin.

16. Bovine facies (Craniofacial Dysostosis or Crouzon syndrome)

Convex nasal profile, shortened mandible, macroglossia.

17. Bell’s palsy (Facial nerve dysfunction)

The eyelids on the paralyzed side can’t close. The mouth is drawn to the unparalyzed side, producing a somewhat grotesque appearance. Food and drink dribble from the mouth on the paralyzed side. The eye with the involved lid dries due to decreased tear production.

18. Amiodarone facies

Deep blue discoloration around malar area and nose.