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Note what signs you see.
I (W. Wertelecki, M.D.) see a facies (in medical parlance, a face suggestive of a clinical disorder). In this instance detailed complete clinical examination is indicated. From this single image I suspect that this woman is small and has signs of premature aging; relative lack of hair (hypotrichosis) in particular of the lateral eyebrows; coarse (thick) facial folds and perhaps thickened upper eyelids; on the right side of the neck there may be a swelling, perhaps the thyroid (goiter?).
This image, among others, was collected by Dr. Josef Warkany in the Alpine Tyrol region of Austria, inhabited by many victims of iodine deficiency manifested as epidemic of goiter and instances of cretinism, terms considered today somewhat obsolete and offensive.
For an overall synthesis, please see the related gallery of images.