Keywords
Sympathetic nerves
Erythema
Face
Botulinum toxin
Categories
How to Cite
Abstract
The Harlequin syndrome is a rare and benign disorder of the sympathetic nerves that is mostly idiopathic. It is characterized by an erythema associated with an intense sweating of one side of the face, and a pallor and anhidrosis of the other side. A complete workup to rule out secondary organic causes should be done properly. The medical or surgical options are only required if the patient is in demand of treatment. Psychological and social impacts of this condition should be considered while consulting patients for treatment options. We report a case of a 24 years old female patient who presented this syndrome during exercise and heat stress. She improved considerably after botulinum toxin injections.
References
Lance JW, Drummond PD, Gandevia SC, Morris JG. Harlequin syndrome: the sudden onset of unilateral ushing and sweating. J Neurol Neurosurg Psychiatry. 1988 May;51(5):635-42. https://doi.org/10.1136/jnnp.51.5.635
Algahtani H, Shirah B, Algahtani R, Alkahtani A. Idiopathic harlequin syndrome manifesting during exercise: a case report and review ofthe literature. Case Reports in Medicine. 2017;2017:5342593. https://doi.org/10.1155/2017/5342593
Elboukhari K, Baybay H, Elloudi S, Douhi Z, Mernissi FZ. Idiopathic harlequin syndrome: a case report and literature review. Pan Afr Med J. 2019 Jun 25;33:141. https://doi.org/10.11604/pamj.2019.33.141.18102
Hans-Bittner NR, Bitner GC, Hans Filho G. Do you know this syndrome? Harlequin syndrome. An Bras Dermatol.2018;93(4):585-6. https://doi.org/10.1590/abd1806-4841.20187549
Yeong JJ, Jongbae S, Jong HC. Harlequin syndrome following resection of mediastinal ganglioneuroma. Korean J Thorac Cardiovasc Surg. 2017 Apr;50(2):130-132. https://doi.org/10.5090/kjtcs.2017.50.2.130
Dong HL, Jong YS, Tae MY, Joon KL, Sang CL. Harlequin syndrome and Horner syndrome after neck schwannoma excision in a pediatric patient. Medicine (Baltimore). 2017 Nov;96(45):e8548.. https://doi.org/10.1097/md.0000000000008548
Kim JY, Lee MS, Kim SY, Kim HJ, Lee SJ, You CW, et al. A pediatric case of idiopathic Harlequin syndrome. Korean J Pediatr. 2016 Nov;59(Suppl 1):S125-S128. https://doi.org/10.3345/kjp.2016.59.11.s125
Reddy H, Fatah S, Gulve A, Carmichael AJ. Novel management of harlequin syndrome with stellate ganglion block. Br J Dermatol. 2013 Oct;169(4):954-6. https://doi.org/10.1111/bjd.12561
Manhães RK, Spitz M, Vasconcellos LF. Botulinum toxin for treatment of Harlequin syndrome. Parkinsonism Relat Disord. 2016 Feb;23:112-3. https://doi.org/10.1016/j.parkreldis.2015.11.030
Emsley HCA, Postexertional Harlequin syndrome with spontaneous improvement. BMJ Case Rep. 2013 Sep 2;2013:bcr2013200516. https://doi.org/10.1136/bcr-2013-200516
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2021 Hajjij A et al.
