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The distinguishing factor between heat stroke and heat exhaustion is the skin condition associated with heat stroke, which is red, hot, and dry. In cases of heat stroke, the body's thermoregulation fails, leading to a significant rise in body temperature (often exceeding 104°F or 40°C), and the person may stop sweating, resulting in dry skin.

This absence of sweating is critical because it signifies the body's inability to cool down, which can lead to severe complications. In contrast, heat exhaustion typically presents with heavy sweating, cool skin, and other symptoms such as weakness, nausea, or dizziness, indicating that the body is still attempting to regulate its temperature.

The presence of a rapid weak pulse can occur in both conditions, but it does not uniquely identify heat stroke. A normal body temperature would be inconsistent with heat stroke, as it is characterized by a dangerously elevated body temperature. Heavy sweating is more aligned with heat exhaustion and would not be expected in someone experiencing heat stroke. The unique hallmark of skin that is red, hot, and dry effectively distinguishes heat stroke from heat exhaustion.