parry  romberg syndrome is a condition characterized by a slowly progressive shrinkage of the soft tissues , and sometimes bones of the face , unilaterally and occasionally bilaterally . atrophy of the facial tissues including muscles , bones , and skin of one side are usually noticed in this condition . this condition , otherwise known as progressive hemifacial atrophy , as labelled by eulenberg ( 1871 ) , is very rare and was first described by caleb parry in 1815 followed by maritz romberg in 1846 . this condition results in several aesthetic , functional , and psychological problems when the symmetry of the face is lost . the incidence and cause of this condition is unknown , however , a cerebral disturbance on fat metabolism is blamed . trauma , viral infection , endocrine disturbances , autoimmunity , and heredity have also been implicated in the pathogenesis . it manifests in the first and second decade of life , beginning as atrophy of the skin and subcutaneous structure of the face , and progresses at a variable rate affecting the dermatomes of one or more branches of the trigeminal nerve , and then becomes stable . hypoplasia of the underlying bone may also occur if the condition starts during the first decade . other associated conditions are ocular changes , neurologic disturbances , such as focal epileptiform seizures , and trigeminal neuralgia . many times the affected skin shows discolouration due to hypopigmentation or hyperpigmentation before the atrophy sets in . there is a high incidence noticed in females then males . here , we present a case of parry  romberg syndrome with unilateral progressive atrophy of one side of the face along with unilateral involvement of the entire body which is rarely encountered . a 21-year - old male patient reported to the outpatient department of kalinga institute of dental sciences with a complaint of progressive deformity of the right side of the face since last 9 years . on examination , the patient had asymmetry of face on the right side with marked hypoplasia and hyperpigmentation of the skin . there was a linear scar ( coup de sabre ) extending from the forehead to mandibular menton dividing the affected side from the unaffected . on intraoral examination , right side soft palate and faucial area showed atrophy [ figure 2 ] . general examination revealed that the entire right side of the body was atrophied when compared with the left side [ figure 3 ] . cone beam computed tomography ( cbct ) three - dimensional ( 3d ) reconstruction showed decreased vertical height of the right side mandible compared to the left side [ figure 4 ] . surgical intervention and alloplastic fat graft was suggested to the patient but he refused any such intervention due to financial constraints . facial profile showing marked hypoplasia of the right side of the face resulting in facial asymmetry intraoral image showing atrophy of the right side soft palate and faucial area right side of the body shows atrophy in comparison to the left side cone beam computed tomography image showing decreased vertical height of the right side mandible parry  romberg syndrome is a degenerative condition which is uncommon in nature . a slowly progressive unilateral atrophy involving the facial tissue , including muscles bones and skin , is characteristic of this condition . viral infection , trauma , endocrine imbalance , autoimmunity , and heredity are considered to be pathogenetic . the condition has a high female predilection and presents mostly on the left side of the face . however , in our case the patient was male and had presentation on the right side . the skin can be dry and can show pigmentation . a demarcation line can be present between the normal and abnormal skin , mimicking a big linear scar called coup de sabre . other common complications are eyelid atrophy , uveitis , retinal vasculitis , occulomotor defects , and glaucoma . some patients present with smaller ear on the affected side due to atrophy . alopecia is also reported on the affected side , as seen in the present case on the right parietal region and right eyebrow . cases may be associated with neurological complications such as trigeminal neuralgia , movement disorders secondary to brain lesions , hemiplegic migraines , facial palsy , headache , epilepsy , behavioral changes , sympathetic hyperactivity , progressive intellectual deterioration due to cerebral hemiatrophy ( rasmussen encephalitis ) , and occulomotor nerve palsy . frank elevation of the mouth , nose , facial midline , and dental midline is characteristic . hemifacial microsomia ( first and second branchial arch syndrome ) and its variants such as goldenhar syndrome , post - traumatic atrophy , and partial lipodystrophy ( barraquer - simon syndrome ) can be considered in the differential diagnosis . transfer of autologous fat tissue to the affected side , silicon injection , inorganic implants , and bovine collagen are few modalities that have been explored . romberg syndrome is advocated to be used for progressive hemifacial atrophy without features of cutaneous scleroderma . hence , it can be suggested that localized scleroderma and parry  romberg syndrome may represent the same disease process . parry  romberg syndrome or progressive hemifacial atrophy is an uncommon condition whose pathophysiology is poorly understood . involvement of one side of the body is still a rarity , which is seldom ever encountered . such a rare case with involvement of entire half of the body is reported in the present case . treatment of such cases becomes a challenge as we do not have treatment options to offer . poorly understood conditions like this should be highlighted in the literature for enhancing the clinical acumen . the authors certify that they have obtained all appropriate patient consent forms . in the form the patient(s ) has / have given his / her / their consent for his / her / their images and other clinical information to be reported in the journal . the patients understand that their names and initials will not be published and due efforts will be made to conceal their identity , but anonymity can not be guaranteed . the authors certify that they have obtained all appropriate patient consent forms . in the form the patient(s ) has / have given his / her / their consent for his / her / their images and other clinical information to be reported in the journal . the patients understand that their names and initials will not be published and due efforts will be made to conceal their identity , but anonymity can not be guaranteed .
parry - romberg syndrome , which is also known as progressive hemifacial atrophy , is a poorly understood rare condition . in this condition , 
 the face shows unilateral , slowly progressive atrophy . 
 disturbance in fat metabolism , viral infection , trauma , heredity , endocrinal disturbances , and autoimmunity are few possible factors in its pathogenesis . 
 rarely , only this syndrome progresses and involves one half of the body . 
 our attempt is to present a case of parry  romberg syndrome involving one half of the body , which is a rarity in itself .