Dear friends,

This is a rare case which was seen by one of my former colleagues who is an internal medicine doctor residing currently in Liberia for a certain governmental mission. His patient presented with blurred vision , and itching mainly on the upper eyelids. As the pictures shows he has swelling of both upper and lower lips as well as bilateral swelling of upper eyelids. Unfortunately the only available diagnostic tool was CAT scan which showed no bone destruction or infections (Unfortunately the imaging studies were interpreted by a radiology tech of very limited training experience, it seems there is no availability of radiologists to read it). The patient`s past medical history was a headache of 5 years duration for which he received traditional medicine. He was never seen by a doctor uptill now when he presented as the picture shows. Its true all of us are fortunate that we live in a country which provides us with the best means of health services...but what's breaking my heart is knowing that there are many countries in this world which are incapable of providing their citizens with the minimal essential tools of diagnosing a disease. This patient is for sure suffering and his physician feels helpless with the limited diagnostic tools offered at his place. Is there any way of reaching a differential diagnosis to this case without a biopsy ? Of note; there is no way to do a biopsy seems this service is not present at all....I am trying to get the cat scan picture if possible

I need an advice can we help such a patient and do something ...

any suggestions are highly appreciated

Appreciate any feedback

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