Leonardo da Vinci's Mona Lisa: Medical Differentials and Primary Biliary Cholangitis

The Mona Lisa or La Gioconda is considered the most celebrated; most revered and most visited art piece in the world. Studying the image from the Louvre, it is clear that the subject's left eye clearly depicts a lesion consistent with a left eye xanthelasma. Other elements have also been considered including the fact that there are no eyebrows or eyelashes which may represent madarosis (Greek madao 'fall off') with a myriad of autoimmune, systemic and dermatological causes. Additional autoimmune possibilities include underlying hypothyroidism as there are also 'puffy eyes'. The issue of madarosis is generally discounted as spectrographic imaging[1] of the piece does reveal that eyebrows did exist on the original painting and were likely chemically deleted during painting maintenance. Some authors have suggested the possibility of a right eye or hand lipoma although this is not fully clear when assessing the image. The longstanding suggestion of Bell's palsy is difficult to ratify in the context of a normal smile.