Atypical Trigeminal Trophic Syndrome: An Unusual Cause of Facial Ulceration

Kentley, Jonathan; Marshall, Claire; Gkini, Maria-Angeliki; Taylor, R.; Bewley, Anthony

doi:10.2340/00015555-2675

Cited by 10 publications

(14 citation statements)

References 10 publications

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“…Although typically unilateral, a case of bilateral TTS was recently reported . Other atypical locations include on the lip, cheek, forehead, scalp, ear, jaw, and palate .…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Biopsies reveal no evidence of malignancy or infection. Instead, they have been reported to show ulceration with adjacent lichenification and epidermal and dermal scarring with mild mixed inflammatory cell infiltrate . Reports of acanthosis, hypergranulosis, and hyperkeratosis are common …”

Section: Histology Of Trigeminal Trophic Syndromementioning

confidence: 99%

“…Histology is nondiagnostic because it only shows chronic ulceration with minimal inflammatory infiltrate with no giant cells, granulomas, or vasculitic lesions . Mild chronic inflammation of facial sinuses in magnetic resonance craniofacial imaging has been reported . However, diagnostic strategy remains requiring exclusion of all other main causes of ulcers located on the face …”

Section: Diagnosis Of Trigeminal Trophic Syndromementioning

confidence: 99%

“…Patients with TTS are commonly misdiagnosed with dermatitis artefacta, but intractable facial sensations described by the patient and the characteristic distribution of the lesion should suggest TTS . In addition, in contrast to dermatitis artefacta, patients describe a sense of intense relief on skin picking and admit to voluntary picking …”

Section: Differential Diagnosismentioning

confidence: 99%

“…5 Although typically unilateral, a case of bilateral TTS was recently reported. 15 Other atypical locations include on the lip, cheek, forehead, scalp, ear, jaw, and palate. 16 Rare and extreme cases penetrating the eyes, bones, sinuses, and brain have also been reported.…”

Section: Pathogenesis Of Trigeminal Trophic Syndromementioning

confidence: 99%

See 4 more Smart Citations

Trigeminal trophic syndrome: an updated review

2018

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Trigeminal trophic syndrome (TTS) is a rare disease process that is thought to occur after insult to the trigeminal nerve. The earliest descriptions of this condition were provided in the early 20th century, yet it remains relatively unknown, with approximately 200 cases since described. Most commonly seen in older women, TTS characteristically involves persistent facial ulceration with loss of sensation and paresthesia along the distribution of the trigeminal dermatome. Ulceration often occurs in the alar region, following self-manipulation in response to paresthesias. Time of onset of TTS after trigeminal insult may vary from weeks to decades, and emergence of ulceration may be associated with psychiatric disorders. Diagnosis is clinical and made by exclusion of similarly presenting conditions. Histology is nonspecific yet necessary to exclude other causes of facial ulceration. Although there is not yet a standard management strategy, a number of successful approaches have been reported including pharmaceutical and surgical interventions, installation of a protector, and transcutaneous nerve stimulation. However, because of the self-inflicted manifestations of this disorder, behavioral modifications remain of the utmost importance. This review serves to address the history, epidemiology, pathogenesis, clinical presentation, histology, diagnosis, differential diagnosis, and management options for TTS.

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“…Although typically unilateral, a case of bilateral TTS was recently reported . Other atypical locations include on the lip, cheek, forehead, scalp, ear, jaw, and palate .…”

Section: Clinical Featuresmentioning

confidence: 99%

Section: Histology Of Trigeminal Trophic Syndromementioning

confidence: 99%

Section: Diagnosis Of Trigeminal Trophic Syndromementioning

confidence: 99%

Section: Differential Diagnosismentioning

confidence: 99%

Section: Pathogenesis Of Trigeminal Trophic Syndromementioning

confidence: 99%

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Trigeminal trophic syndrome: an updated review

2018

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Trigeminal trophic syndrome associated with neuralgia after ischemic stroke—a case report

Rybak‐d′Obyrn,

Alicja,

Joanna

et al. 2023

Clinical Case Reports

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Trigeminal trophic syndrome (TTS) is a rare condition resulting from self‐manipulation of the skin after an injury to the trigeminal nerve. We describe the case of a 70‐year‐old woman who was hospitalized because of erythema, ulceration, and crusts on the right side of her face, accompanied by itching, burning, and irritation forcing self‐manipulation of the skin. She had been previously repeatedly treated with antibiotics, acyclovir, and topical medications without any improvement. Her medical history revealed an episode of ischemic stroke in 2016, after which a deformation and partial atrophy of the right ala nasi appeared. Trigeminal neuropathy was confirmed by a neurological consultation. Diagnosis and treatment of TTS requires a multidisciplinary approach. Awareness of this disease should be raised to enable proper diagnosis and management of difficult‐to‐treat facial ulcers that cannot be explained by common causes.

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Trigeminal Trophic Syndrome

Kentley

Ahmed

2021

Psychodermatology in Clinical Practice

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Atypical Trigeminal Trophic Syndrome: An Unusual Cause of Facial Ulceration

Cited by 10 publications

References 10 publications

Trigeminal trophic syndrome: an updated review

Trigeminal trophic syndrome: an updated review

Trigeminal trophic syndrome associated with neuralgia after ischemic stroke—a case report

Trigeminal Trophic Syndrome

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