Image Challenge – October 21

Question: What is the name of the clinical sign in the image below? What the the most likely underlying diagnosis?

Answer: In this image, we see Queen Anne sign, a loss of the outer third of the eyebrows. The patient in the image also has hair thinning, xerosis, and perioribital edema. Queen Anne sign, and the associated findings in the image, are found in severe hypothyroidism. This patient’s thyrotropin level was 204 (normal 0.35–4.94) mIU/L, and his free thyroxine and triiodothyronine levels were undetectable! 


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