How to diagnose facial atrophy

Facial atrophy is a relatively serious disease. The onset of this disease is relatively hidden. Usually, the left side of the patient's face will gradually develop and eventually cause complete atrophy, seriously affecting the patient's appearance. Certain symptoms will also appear. To determine whether the face is atrophied, you can compare the left and right faces. In addition, for example, migraines, sensory disorders, etc., these are all better judgment methods.

How to diagnose facial atrophy

1. Progressive systemic sclerosis

It is a rheumatic disease, one type of which is limited to the skin, while the other type also affects the internal organs. They are usually women of childbearing age between 20 and 50 years old, with a male to female ratio of about 1:2 to 3. It often starts with Raynaud's phenomenon (90%) or symmetrical swelling and stiffness of the fingers. Skin lesions are usually seen first on the fingers, hands or face, showing swelling and edema without indentation (swelling stage). Then the skin thickens and hardens like leather, without luster (sclerosis stage). Finally, the skin atrophies (atrophy stage). The skin lesions gradually spread to the arms, neck, chest and abdomen. The normal facial skin wrinkles disappear, the face becomes rigid, it is difficult to open the mouth, and the hardened areas become pigmented with depigmented spots in between.

(ii) Facioscapulohumeral muscular dystrophy

A slowly progressive atrophy of the facial muscles that occurs in adolescents. The distinctive "myopathy face" is characterized by slightly ptosis of the upper eyelid, disappearance of the forehead wrinkles and nasolabial grooves, weak or absent facial movements, and the lips appear thickened and slightly upturned (cat face) due to the rigid hypertrophy of the orbicularis oris muscle. The patient is unable to close the eyes tightly, cannot blow air into the cheeks, has atrophy of the brachial, shoulder and facial muscles, is unable to lift the upper arms, and has a wing-like breakthrough of the scapula when the upper limbs are raised horizontally. The activities of serum pyruvate kinase (PK), pyruvate kinase (CPK), etc. are increased.

3. Progressive lipodystrophy

It is more common in females, with onset usually around 5 to 10 years old, often symmetrically distributed, and slow progression. It is characterized by progressive disappearance of subcutaneous fat or weight loss, which starts on the face, with sunken cheeks and temples, loose skin, loss of normal elasticity, and sunken eye sockets, followed by the neck, shoulders, arms and trunk. In some cases, the lesions are limited to the face or half of the face or half of the body, which may be confused with Parry-Rombery syndrome, but the biopsy of the former only shows the disappearance of subcutaneous fat tissue.