What is your diagnosis if this case appear in skin substation? It is not JVP nor Corrigan's sign! It is a thicken great auricular nerve.
Think of Hansen's disease (Leprosy) in this case. You may see this case in Malaysia PACES center.
The next step is to search for a skin lesion with sensory loss. Ask for contact history
Hypopigmented macules in confluence (patches) of tuberculoid leprosy.
"Leonine facies" of diffuse lepromatous leprosy.
Thanks to eMRCPian.
ReplyDeleteHonestly, till now i have not see any leprosy case in the real clinical practice, only in pics and atlases off course.
I wonder if eMRCPian is able to make a video clip (say up to 1MB) of this patient featuring the thickened nerve.
I think that the 3rd pic of a leonine face is not typical of those published in books and atlases.
Regards...
Dr. O Amin
Neurologist and Head of Team Neurology4MRCPGroup
I dont have the video clip of this patient.
ReplyDeleteThis comment has been removed by the author.
ReplyDeleteLeprosy is not uncommon in Malaysia though we had achieved the WHO standard.
ReplyDeleteWhat does the thickened nerve feel like?
ReplyDeleteIf you want to see leprosy,
can also come to Sarawak. The dermatology unit at Sarawak General Hospital treats a lot of these patients and there actually is a thriving leper colony outside Kuching.
Actually, these ex-lepers have completed their treatment but the stigma remains so they remain in the colony.
The nerve feel like a cord.
ReplyDeleteSo, when is your 1st sharing article?