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7th July 2010

Saggy eyes

posted in - Palmdoc, - Photoblog, - Quiz |

A patient was referred by an ophthalmologist for “saggy eyes” which appeared to be a bit “bruised”. Her platelet count was mildly low at 136×10^9/l.

eyes
hands

What is the diagnosis?
What further investigations would you do?

OK, might be a little difficult this one, so here are some clues.

1) The patient volunteered that she has been having weakness in the legs of late.
2) Look carefully at her hands, especially the dorsal aspect.
3) Think of a flower.

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This entry was posted on Wednesday, July 7th, 2010 at 4:16 pm and is filed under - Palmdoc, - Photoblog, - Quiz. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.

4 Responses to “Saggy eyes”

  1. 1
    Gravatar ahhau Says:
    July 9th, 2010 at 3:58 am

    dermatomyositis

  2. 2
    Gravatar fooji Says:
    July 15th, 2010 at 11:31 pm

    a variant of Raynaud’s?

  3. 3
    Gravatar Jimbo Says:
    July 16th, 2010 at 8:55 am

    Heliotrope rash around eyes, Gottron’s papules on dorsum of hand and proximal muscle weakness. All in keeping with dermatomyositis. Not sure about her age but I think she is elderly, so need to rule out underlying malignancy.

  4. 4
    Gravatar Palmdoc Says:
    July 16th, 2010 at 8:58 am

    Dermatomyositis is the correct diagnosis.
    CK is 660 iu/l, in 2009 she was diagnosed to have cervical cancer apparently in remission now.

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