Ross Syndrome - A Rare Disorder of Sweating, Areflexia, and Tonic Pupil.

Sweating is a physiological process that is essential to maintain the temperature of the human body. Any derangement with this process leads to not only physical disturbances but can also cause psychological and social disturbances. Localized hyperhidrosis can have many causes. It can be a normal physiological response to local heat and pressure or it may be secondary to some pathological conditions causing local vasomotor disturbances (peripheral neuropathy or spinal injury) or sometimes it's secondary to neurological problems like tumour, inflammation and damage affecting the central nervous system, autoimmunity, viral infections and genetic disorders. Classically, Ross syndrome was described in 1958; it is a triad of Adie's pupil, areflexia and segmental hypohidrosis or anhidrosis.1 Anhidrosis is secondary to damage to the postganglionic cholinergic fibres that supply the sweat glands and in compensation, to the absent sweating in the affected segments there is over sweating elsewhere.2 Most of the times it is this excessive sweating that bothers the patient the most, in our case report we describe a patient who had excessive sweating over the left trunk and left lower limb which was, in fact, anhidrosis on the opposite side.Ross syndrome is a rare entity, (defined a clinical trial of segmental anhidrosis or hypohidrosis, areflexia, and atonic pupil. It is a progressive and complex disorder of Thermoregulation. The first component of the triad defines Harlequin syndrome and the last two defines Holmes-Adie syndrome). Ross syndrome has an unpredictable course. Usually, it presents with the absence of sweating in a particular area of the body which causes heat intolerance to the patient. There are only a few cases in the literature, here we present to you a case of Ross syndrome presenting with hyperhidrosis on the left side of the trunk and left lower limb. We intend this case report to inform academics and clinicians of various modalities about this entity, especially to the dermatologists, physicians and neurologists as patients usually present with this complex disorder to them.