Head & Face

Differential Diagnosis:

    • Congenital lesions-

      • Hydrocephalus-

      • Meningocele-

      • Encephalocele-

      • Meningo-encephalocele-

      • Dermoid cysts-

      • Cleft lip-

      • Cleft palate-

      • Bifid nose-

      • Facial cleft-

      • Macrostoma-

      • Macrocheilia-

      • Mandibular cleft-

      • Pre-auricular sinus-

      • Congenital short frenum of the upper lip-

      • Congenital fistulae of the lower lip-

    • Traumatic lesions-

      • Haematoma of the scalp-

      • Cephal haematoma-

    • Inflammatory lesions-

      • Pott's puffy tumour-

      • Boils, carbuncles, cellulitis, erysipelas-

    • Ulcers-

      • Lupus vulgaris-

      • Rodent ulcer-

      • Actinomycosis-

      • Carcinoma of the lip-

      • Extragenital chancre or mucous patches or condylomas-

    • Tumours & Cysts-

      • Benign tumours-

      • Haemangioma-

      • Osteoma-

      • Malignant tumours-

      • Cylindroma-

      • Secondary carcinoma-

      • Paget's disease of the skull-

      • Cysts, Sebaceous cysts-

Some characteristic facies-

    • The Hippocratic facies- This characteristic facial appearance is almost pathognomonic of advanced diffuse peritonitis. The eyes are sunken, but bright, the nose is pinched. The forehead is cold and clammy. There are crust on the lips. The tongue is dry and shrivelled. It is in fact due to dehydration rather than peritonitis that the appearance of sharp nose, hollow eyes and collapsed temples are produced. But when this facial appearance is combined with thready pulse and a grossly distended abdomen, the condition is nothing but an advanced case of diffuse peritonitis.

    • The facies of Hepatic cirrhosis- The eyes are sunken and there is variable degree of icterus present in the watery conjuntivae. There is also presence of spider naevi and all these indicate a moderately advanced case of hepatic cirrhosis.

    • The Adenoid facies- A high arched palate, narrow dental arch and protruding incisor teeth are the characteristic features found in a patient with enlarged adenoids. However this concept has been challenged nowadays and these features are not considered to be pathognomonic of enlarged adenoids.

    • The Moonface of Cushing's syndrome- The face becomes round shaped like a full moon and often the lips are pursed in a case of Cushing's syndrome.

    • The facies of Cretinism- The face is pale, puffy and wrinkled. The skin is dry and cold. The tongue is protruded. The anterior fontanelle remains open. The thyroid gland may or may not be enlarged. This is characteristic appearance of a case of cretinism.

    • Carcinoid facies-This occurs when a carcinoid tumour metastases in the liver and excess of serotonin is secreted. This condition produces characteristic facial flushing, which is known as carcinoid facies.

Oral Cancer