Facial plethora: modern technology for quantifying an ancient clinical sign and its use in Cushing syndrome

Authors

• A Afshari
• Y Ardeshirpour
• MB Lodish
• E Gourgari
• N Sinaii
• M Keil
• E Belyavskaya
• C Lyssikatos
• FA Chowdhry
• V Chernomordik
• AA Anderson
• TA Mazzuchi
• A Gandjbakhche
• CA Stratakis

Abstract

Facial plethora is a clinical sign described since ancient times for a variety of diseases. In the 19th century, it was linked to increased blood volume or flow but this has never been proven. Facial plethora is also one of the early described clinical features of Cushing’s syndrome (CS). This study aimed to quantify FP changes in CS as an early assessment of cure following surgery using new technology. Non-invasive multi-spectral near-infrared imaging (MSI) was performed on the right cheek of patients before and 4.9 ± 3.1 days after surgery. Clinical data obtained from 34 patients indicate that a decrease in facial plethora after surgery as evidenced by a decrease in blood volume fraction is linked with cure of CS. This novel technology for the first time identified a physiologic mechanism associated with an ancient clinical sign. Furthermore, as a proof of principle, MSI is a promising early marker of cure in patients with CS that compliments biochemical and clinical data.

Scientific Focus Area: Biomedical Engineering and Biophysics

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