Parry–Romberg Syndrome in Tow Young Afghan Patients: First Case Report

Abstract

Parry–Romberg syndrome (PRS), or progressive hemifacial atrophy, is a rare neurocutaneous disorder characterized by unilateral, slowly progressive atrophy of facial soft tissues and, in some cases, underlying bone. Reports from South-Central Asia are scarce, and no confirmed cases have previously been documented from Afghanistan. We report two young Afghan patients—an 18-year-old male and a 22-year-old female—who presented with insidious, progressive left-sided facial atrophy without prior trauma, infection, or autoimmune disease. Clinical examination revealed unilateral soft-tissue wasting, skin thinning, and facial asymmetry, with normal neurological findings. Computed tomography demonstrated atrophy of subcutaneous fat and facial musculature with subtle osseous thinning. Follow-up over 6 and 4 months showed no further progression. Quantitative imaging revealed an 18–22% reduction in soft-tissue thickness in one patient and 15–17% in the other. The left-sided predominance observed is consistent with international reports. Although the etiology of PRS remains unclear, early recognition is essential due to its functional, aesthetic, and psychosocial impact. These cases highlight potential underdiagnosis in low-resource settings and emphasize the importance of reporting PRS from underrepresented regions.