Evidence of a possible Parry-Romberg Syndrome in an 18th-19th Century Orthodox Votive Plaque.

Votive offerings (ex-voto) are material objects deposited in sacred spaces as expressions of gratitude, petitions for divine assistance, or as part of consecration rituals. In Eastern Orthodox Christianity, particularly in Greece and the Balkan region, these offerings frequently take the form of tamata; these are small metal votive plaques depicting body parts or organs often rendered with a high degree of realism. Here we report previously unreported tama depicting a child/young adolescent with features suggestive of Parry-Romberg syndrome also known as progressive hemifacial atrophy. The 18th-19th century collection of votive offerings from the Orthodox Monastery of Florești (Romania) was examined. Among the seven identified objects, one tama portrays a child/adolescent, approximately 10-15 years of age, in the shape of an angel, with evident pathological features. The artifact was carefully examined by a multidisciplinary team following the International Guidelines for Iconodiagnosis in order to establish a consensus diagnosis and to determine the level of iconodiagnostic evidence. The votive plaque displays right-sided hemifacial atrophy, ipsilateral enophthalmos, and atrophy of the right upper and lower limbs. A deliberate reduction in the size of the right wing compared to the contralateral side is also evident. Correlation of these morphological features with clinical data from the medical literature supports the iconodiagnostic hypothesis of Parry-Romberg syndrome with possible ipsilateral extension to both the upper and lower limbs (level II iconodiagnostic evidence). This tama may represent an early Orthodox votive depiction of Parry-Romberg syndrome. This finding highlights the value of votive collections as interdisciplinary sources for the historical documentation of rare diseases and for the application of iconodiagnosis within a religious context.