FACIAL EXPRESSIONS BROUGHT ABOUT BY EFFECTS OF DISEASES OR

IMPENDING DEATH

HIPPOCRATIC

The Hippocratic face (facies Hippocratica in Latin) is the change produced in the face by
impending death or long illness, excessive evacuations, excessive hunger, and the like.

"[If the patient's facial] appearance may be described thus: the nose sharp, the eyes
sunken, the temples fallen in, the ears cold and drawn in and their lobes distorted, the
skin of the face hard, stretched and dry, and the colour of the face pale or dusky…and
if there is no improvement within [a prescribed period of time], it must be realized that
this sign portends death." The Hippocratic face is so called because it was first described
by Hippocrates. A related term is cachexia.
MYXEDEMA

Myxedema is an ailment that is characterized by a thickened and enlarged skin. The

condition is prompted by the reduced production of the thyroid hormone by the thyroid
gland. Myxedema is merely brought about by hypothyroidism.

Hypothyroidism mostly affects women, but a considerable number of male infections

have been recorded over the years. Mostly the ailment touches older women. There are
a number of causes that are a purported to bring about the condition. These include:

Viral infections

Side effects of taking certain medications

Longtime contact with radioactive materials

Myxedema’s symptoms are sometimes too challenging and in most occasions weigh
heavily on the lives and health of the victims. Patients living with the disease have an
enlarged skin which appears rough and swollen. The skin also seems to be dehydrated
and deprived of essential nutrients. This is characterized by the change in appearance
turning it to a yellow like color to the extremes of orange. The inflamed skin is a result
of a layer of jelly substance concealed under some part of the skin. The symptoms and
severity of the condition is characterized differently among diverse patients. The ailment
can either be expressed partially or fully. Rarely does the disease affect partially, legs
only, but in most cases affect the body as a whole. In such occasions, the symptoms
tend to more severe as the inflammation covers a large percentage of the body cover.
MONGOLIAN

Down syndrome (DS or DNS), also known as trisomy 21, is a genetic disorder caused by
the presence of all or part of a third copy of chromosome 21. It is typically associated
with physical growth delays, characteristic facial features and mild to moderate
intellectual disability. The average IQ of a young adult with Down syndrome is 50,
equivalent to the mental ability of an 8- or 9-year-old child, but this can vary widely.

Signs and symptoms

Those with Down syndrome nearly always have physical and intellectual disabilities. As
adults, their mental abilities are typically similar to those of an 8- or 9-year-old. They
also typically have poor immune function and generally reach developmental milestones
at a later age. They have an increased risk of a number of other health problems,
including congenital heart defect, epilepsy, leukemia, thyroid diseases, and mental
disorders, among others.

Physical

People with Down syndrome may have some or all of these physical characteristics: a
small chin, slanted eyes, poor muscle tone, a flat nasal bridge, a single crease of the
palm, and a protruding tongue due to a small mouth and relatively large tongue. These
airway changes lead to obstructive sleep apnea in around half of those with Down
syndrome. Other common features include: a flat and wide face, a short neck, excessive
joint flexibility, extra space between big toe and second toe, abnormal patterns on the
fingertips and short fingers. Instability of the atlantoaxial joint occurs in about 20% and
may lead to spinal cord injury in 1–2%. Hip dislocations may occur without trauma in
up to a third of people with Down syndrome. Growth in height is slower, resulting in
adults who tend to have short stature—the average height for men is 154 cm (5 ft 1 in)
and for women is 142 cm (4 ft 8 in). Individuals with Down syndrome are at increased
risk for obesity as they age.
LEONINE

Leonine facies: a face that resembles that of a lion. It is seen in multiple conditions and
has been classically described for Lepromatous leprosy as well as Paget's disease of
bone. It is a dermatological symptom, with characteristic facial features that are visible
on presentation and is useful for focusing on differential diagnosis.

Above: Additional drawings of 19th century leprosy patients. From left, the man
demonstrates facial paralysis, demonstrative of facial nerve involvement. The woman in
the center not only has nodules, but also loss of eyebrows and what appears to be
scarring of the right eye. The right most woman, who at the time is said to be 28 years
old, has extensive, disfiguring nodular leprosy; all three have multibacillary leprosy.
Photo Credit: Peter Richards, The Medieval Leper, 2000