“Panting sign” as a clinical clue to heat stress in hypohidrotic ectodermal dysplasia

A 1-year-old male child, born of a non-consanguineous marriage, presented with sparse scalp hair and the absence of dentition since birth.Clinical examination revealed anhidrosis, an underdeveloped mandible, and thick, everted lips [Figure 1a].e nails were normal.e starchiodine test revealed a complete absence of sweating.ere was no family history of similar complaints in a three-generation pedigree chart.e parents also reported a recurrent pattern during heat exposure or physical exertion: e child would become uncomfortable, protrude his tongue, and develop rapid, non-laboured open mouth breathing (panting-like breathing) [Figure 1b].Dermoscopic examination of the chest demonstrated marked reduction of pinpoint white dots (eccrine duct openings/"pores"), supporting a diagnosis of hypohidrotic ectodermal dysplasia (HED) [Figure 2].Genetic testing was not performed due to the financial constraints of the parents.Dermoscopy thus served as a useful, non-invasive adjunct to substantiate hypohidrosis in the absence of molecular confirmation.Conventionally, panting is regarded as a thermolytic strategy in non-human mammals, allowing evaporative cooling from the upper respiratory tract in the absence of sweating.is behavior is www.jsstd.