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Segmental Pallor and Hair Loss in a Patient With Ross Syndrome: Case Report
Markus Augusto Martínez Holst1, Ana María Sierra Valiente1, Francisco Alejandro Silva Navarro1
1Faculty of Medicine, Universidad Anáhuac Mexico, Huixquilucan, Estado de Mexico, Mexico.
The Journal of Dermatology
|August 4, 2026
Summary
Ross syndrome, characterized by Adie's tonic pupil, anhidrosis, and areflexia, presented with unusual facial pallor and alopecia in a long-term case study. This highlights potential broader neurocutaneous manifestations of Ross syndrome.
Area of Science:
- Neurology
- Dermatology
- Ophthalmology
Background:
- Ross syndrome is a rare neurological disorder characterized by Adie's tonic pupil, segmental anhidrosis, and areflexia.
- Neurocutaneous manifestations are skin findings associated with neurological conditions.
- Early recognition of Ross syndrome is crucial for patient management.
Purpose of the Study:
- To report an unusual case of Ross syndrome with extended follow-up.
- To document novel neurocutaneous findings in a patient with Ross syndrome.
- To broaden the understanding of Ross syndrome's clinical spectrum.
Main Methods:
- Case report of a 30-year-old male with sudden anisocoria.
- Clinical examination for Adie's tonic pupil, anhidrosis, hyperhidrosis, and areflexia.
- 15-year follow-up documenting evolving facial manifestations.
Main Results:
- Diagnosis of Ross syndrome confirmed by Adie's tonic pupil, segmental anhidrosis, compensatory hyperhidrosis, and areflexia.
- Development of unilateral facial pallor and alopecia in the affected facial territory over 15 years.
- These findings occurred in a midline-defined pattern.
Conclusions:
- Ross syndrome can present with rare and extensive neurocutaneous manifestations.
- Facial pallor and alopecia may be part of the broader spectrum of Ross syndrome.
- Dermatologists should be aware of these potential neurocutaneous findings in Ross syndrome.
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