Discussion on pictures - Red face


These are only some of the causes of a 'red face'. You might not be expected to know how to differentiate these, but at least learn the differential diagnosis.


1. This girl came with a history of joint pains for 2 months duration.
What is the likely diagnosis?



This is the malar rash of systemic lupus erythematosus. The clinical history is compatible. Note the sparing of nasolabial folds.


2. This 58 years old lady presented with a history of bilateral shoulder pain and weakness for 3 weeks duration.
What is this physical sign?What is the diagnosis?



This is the well known Heliotrope rash of dermatomyositis. Note the characteristic colour and involvement of the eye lids and the nasolabial folds.




3. This 65 years old lady is under cardiology clinic follow up for chronic shortness of breath.
What is the likely diagnosis?


This facial flushing is very non-specific. Note that it's just erythema and there's no true 'rash' as such. With the clinical history the likely diagnosis is malar rash due to mitral stenosis.



4.  This 74 years old man admitted with 2 months history of episodic facial redness, diarrhea, and wheezing.
What is the probable underlying diagnosis?


Even without looking at the picture, with the classic history you can make the diagnosis of carcinoid syndrome.

Comments

Post a Comment

Popular posts from this blog

2 min read - Cirrhosis

Image
A 55 years old male patient admitted to medical casualty with a febrile illness for 3 days with myalgia. Examination was unremarkable. He was previously well except for chronic bilateral knee joint osteoarthritis. He consumed liquor quarter to half a bottle on a daily basis. Investigations revealed. WBC - 5.6 Hb - 11.2 Plt - 135 AST - 45 ALT - 42 S.Cr - 54 He was managed as viral fever and became fever free the next day. However the platelet count was persistently low around 130. Further investigations arranged. Blood picture - Thrombocytopenia probably due to liver disease S. Bilirubin, ALP - Normal S. Albumin - 38, S globulin - 37 USS abdomen - Coarse echogenicity of liver. Mild portal hypertension. Mild splenomegaly. Compatible with chronic liver cell disease. This patient has Cirrhosis with portal hypertension. Now the obvious cause for his cirrhosis is alcohol, isn't it? NO! Just because of the history of significant alcohol consumption you ca
Read more

2 min read - Tachyarrhythmias

Image
A 32 years old previously healthy male patient admitted with a history of palpitations for 1 hour duration. He had experienced a similar episode a few months back which lasted only for few minutes. What are your concerns? First priority is to make sure that the patient is stable. Who is unstable? Hypotensive patient (Systolic BP < 90mmHg) Coronary ischemia (Ischemic chest pain) Cardiac failure (Patient has SOB) Patient with brain hypoperfusion (reduced conscious level) IF ANY OF ABOVE ARE PRESENT IRRESPECTIVE OF THE TYPE OF ARRHYTHMIA YOU WILL HAVE TO PERFORM DC CARDIOVERSION (SHOCK) ECG Analysing tachyarrhythmias is a long topic, which might bore you. Let's learn a few short cuts to diagnose common arrhythmias. Look at the QRS Is it narrow or broad? Narrow complex tachycardias we usually encounter are SVT (Read and understand the proper nomenclature. SVT is a wrong term!) Atrial fibrillation/ flutter In most patients both are managed the s
Read more