- 2025, Volume 83 - Number 4
- Published: October 23, 2025
Harlequin and Horner syndromes with iris heterochromia in pediatrics: report of a congenital case
Marcella Caldeira-Camisasca-Souza 1, Alessandra E. de Morais 1, Naum M. Ribeiro 2, Cláudio do C. Chaves-Filho 3, Virginia V. Figueiras 4, Luciana M. Dos Santos 5
1 Division of Pediatric Dermatology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado - FMT HVD, Manaus, AM, Brazil; 2 Departamento de Medicina, Universidade Federal do Amazonas (UFAM), Manaus, Brazil; 3 Department of Clinical Surgery, Faculty of Medicine, Federal University of Amazonas, Manaus, Brazil; 4 Department of Dermatology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado, FMT HVD, Manaus, AM, Brazil; 5 Department of Pediatric Dermatology, Fundação de Medicina Tropical Doutor Heitor Vieira Dourado - FMT HVD, Manaus, AM, Brazil
Marcella Caldeira-Camisasca-Souza, Alessandra E. de Morais, Naum M. Ribeiro, Cláudio do C. Chaves-Filho, Virginia V. Figueiras, Luciana M. Dos Santos
La información completa de afiliaciones y autor de correspondencia está disponible en la versión original en PDF.
*Correspondence: Alessandra E. de Morais, Email not available
Abstract
Harlequin syndrome is an uncommon disorder characterized by asymmetric sweating and flushing of the face and neck in response to sympathetic stimuli. This report describes a case of congenital origin associated with Horner syndrome and iris heterochromia emphasizing the rarity of this association. Male, 11 years old, presenting since birth with unilateral facial flushing when exposed to sympathetic stimuli. Physical examination revealed miosis, ptosis, enophthalmos, and iris heterochromia. After investigation, the diagnosis of Harlequin syndrome associated with Horner syndrome was confirmed. Harlequin syndrome is an autonomic disorder manifested by anhidrosis and pallor on one side of the face, with contralateral flushing and sweating in response to sympathetic stimuli. The congenital form is commonly related to other syndromes, and in such cases, treatment is conservative, with botulinum toxin considered a minimally invasive option.
