Trigeminal Trophic Syndrome – Case Report
Abstract
Trigeminal trophic syndrome is a rare condition resulting from compulsive self-manipulation of the skin after a peripheral or central injury to the trigeminal system. The classic triad consists of trigeminal anesthesia, facial paresthesias, and crescentric lateral nasal alar erosion and ulceration. Although the symptoms are visibly clear, the diagnosis is not easy to establish. The appearance of the ulcers mimics many other disease entities such as neoplasm, infection, granulomatous disease, vasculitis and factitial dermatitis. Trigeminal trophic syndrome should be considered with a positive neurologic history and when laboratory and biopsy workup is inconclusive. Once diagnosis is confirmed, treatment is complicated and often multidisciplinary. We report a case of a woman who developed a strictly unilateral crescent ulcer of the ala nasi after resection of an statoacoustic neurinoma. A clinician who is faced with a patient with nasal ulceration should consider this diagnosis.
Downloads
References
Ziccardi BV, Rosenthal SM, Ochs WM. Trigeminal Tophic Syndrome: A Case of Maxillofacial Self- Mutilation. Oral Maxillofac Surg 1996; 54:347-350.
Sadeghi P, Papay FA, Vidimos AT. Trigeminal Trophic Syndrome – Report of Four Cases and Review of the Literature. Dermatol Surg 2004; 30: 807–812.
Kautz O, Bruckner-Tuderman L, Müller ML, Schempp CM. Trigeminal trophic syndrome with extensive ulceration following herpes zoster. Eur J Dermatol 2009; 19 (1): 61-3.
Osaki Y, Kubo T, Minami K, Maeda D. Trigeminal Trophic Syndrome: Report of 2 Cases. ePlasty, november 2013.
Sánchez BN, Martín TM, Elicegui FM. Ala Nasal Reconstruction in Trigeminal Trophic Syndrome. Dermatol Surg 2008; 34: 1397–1403.
Frühauf J, Schaider H, Massone C, Kerl H, Müllegger RR. Carbamazepine as the Only Effective Treatment in a 52-Year-Old Man With Trigeminal Trophic Syndrome. Mayo Clin Proc. 2008; 83(4): 502-504.
Bhatti AF, Soggiu D, Orlando A. Trigeminal Trophic Syndrome: Diagnosis and Management Difficulties. PRSJournal 2005.
Rashid RM, Khachemoune A. Trigeminal trophic syndrome. JEADV 2007; 21, 725–731.
Grabovac S, Lukšić I. Trofički sindrom trigeminalnog živca – dijagnoza, liječenje i prognoza. LijeČ Vjesn 2009; 131: 27–29.
Elloumi-Jellouli A, Ben Ammar S, Fenniche S, Zghal M, Marrak H, Mokhtar I. Trigeminal trophic syndrome: A report of two cases with review of literature. Dermatol Online J 2003; 9: 26.
Dicken CH. Trigeminal trophic syndrome. Mayo Clin Proc1997; 72: 543–545.
Curtis AR, Oaklander AL, Johnson A, Yosipovitch G.Trigeminal Trophic Syndrome from Stroke, An Under-Recognized Central Neuropathic Itch Syndrome. Am J Clin Dermatol 2012; 13 (2): 125-128.
Weintraub E, Soltani K, Hekmatpanah J, Lorincz Al. Trigeminal trophic syndrome. A case and review. J Am AcadDermatol 1982; 6: 52-57.
Hancox JG, Wittenberg GF, Yosipovitch G. A Patient With Nasal UlcerationAfter Brain Surgery. Arch Dermatol 2005; 796-798.
Lane JE, Deliduka S. Self-induced Nasal Ulceration From Trigeminal Trophic Syndrome. Cutis 2008; 81: 419-420.
Westerhof W, Bos JD. Trigeminal trophic syndrome: a successful treatment with transcutaneous electrical stimulation. Br J Dermatol 1983; 108 (5): 601-604.
Nelson BR. Trigeminal trophic syndrome. Southern Medical Journal; 2007.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
