Bilateral parotid swelling and calluses on hand (560/1700)

A thin 18yo girl has bilateral parotid swelling with thickened calluses on the dorsum of her hand.
What is the single most likely dx?
a. Bulimia nervosa
b. C1 esterase deficiency
c. Crohn’s disease
d. Mumps
e. Sarcoidosis






























answer: A
Russell's sign, named after British psychiatrist Gerald Russell, is a sign defined as calluses on the knuckles or back of the hand due to repeated self-induced vomiting over long periods of time. The condition generally arises from the afflicted's knuckles making contact with the incisor teeth during the act of inducing the gag reflex at the back of the throat with their finger(s).