Autologous epidermal cells can induce wound closure of neurotrophic ulceration caused by trigeminal trophic syndrome

Trigeminal trophic syndrome

“…In one report by Schwerdtner et al, autologous cultured epidermal cells, mostly of keratinocytes with some fibroblasts were originally taken from a retroauricular skin sample were used with success. 25 A 10-month follow-up showed excellent cosmetic results with no complications. However, this is a single case report and larger trials and long-term outcomes have yet to be done, but the suggestion that neurotrophic secretions to the region stimulated by the transplanted cells could be entertained.…”

“…Spillane et al 8 Ala nasi (2), septum Ulcer and erosion Walton et al 39 Ala nasi (4), septum (2), upper lip Ulcer Owen et al 40 Ala nasi, septum Ulcer Weintraub et al 6 Ala nasi, upper lip, cheek One continuous lesion of a shallow well circumscribed ulcer with shallow bleeding base and erosion Loveman 3 Ala nasi, temple, forehead, angle of eye Carcinomatous-like ulcer and trophic ulcer Karnosh et al 41 Forehead, temple, lip, cheek, nose Well demarcated erythematous plaque Ala nasi, angle of the mouth, cheek, eyelid, chin Red patches of indurated crusted skin. Angle of the jaw, scalp, skin around the ear Kavanagh et al 13 Ala nasi (2), lip and upper lip, cheek Ulceration, erythema, erosion Westerhoff et al 22 Ala nasi, upper lip, check, forhead Superficial sharply demarcated ulcers Data et al 18 Ala nasi, right cheek Ulcer with erythema Elloumi et al 15 Ala nasi (2), upper lip, eyebrow, forehead Non-healing ulcer, well demarcated edges Bhushan et al 24 Ala nasi and cheek Non-healing ulcer/erosion Dicken et al 16 Ala nasi (5), forehead (3), cheek, scalp (2), bridge of nose, chin, bridge of nose Non-healing ulcer, tissue loss and erosion Ferrara et al 42 Ala nasi, forehead and above eyebrow, cheek, chin below lower lip Well defined ulcers with bizarre outlines Munnoch et al 23 Ala nasi, lower eyelid, chin Erosive trophic ulcer Su et al 26 Ala nasi, cheek, forehead, ear, chin Superficial ulcers and destruction of ala nasi Inoue et al 19 Ala nasi, lateral canthus, lower eyelid, upper lip Deep ulcer Mclean et al 43 Ala nasi and septum Ulcer and erosion Howell RG 44 Ala nasi (3) 14 Ala nasi (3), lateral wall of nose (2) Ulcer, punched out defect Macovei et al 46 All over hemi-face (specified ala nasi and upper lip) Trophic ulceration with superficial erosion Schwertdner et al 25 Upper lip Non-healing ulcer Shea et al 20 Nose, upper lip, cheek Ulcer NOTE: Tables were compiled using refs. The trauma and ulcer development/progression follows a classic pattern of a non-healing wound, provoking further injury.…”

“…Recently, in vitro cultured epidermal cells, shown to induce tissue regeneration, have been proposed as an effective tool in the treatment of neurotrophic ulcerations of the face. 25 This transplant of autologous, non-contact-inhibited epidermal cells is an interesting application of recent transplant research. In one report by Schwerdtner et al, autologous cultured epidermal cells, mostly of keratinocytes with some fibroblasts were originally taken from a retroauricular skin sample were used with success.…”

Trigeminal trophic syndrome: an updated review

“…Transcutaneous electrical nerve stimulation may lead to improvement, but relapse is common after discontinuation . Electrical stimulation, negative pressure therapy, and autologous epidermal cell transplant have been investigated with varying degrees of success . Antibiotic therapy, vitamin B treatment, hydrocolloid dressings, cervical sympathectomy, and transcutaneous electrical nerve stimulation to improve blood supply have been reported to result in healing of the wound with good outcome in single case reports .…”

Trigeminal trophic syndrome treated with thermoplastic occlusion

“…Successful treatment of trigeminal trophic syndrome with negative pressure wound therapy was recently reported in a 6-year-old boy, 14 while autologous epidermal cells have been reported to induce healing in a case of trigeminal trophic syndrome with a relatively limited area of ulceration. 15 The poor response of our patient to various treatment modalities is likely to have been contributed to by other compounding factors, such as alcoholism, underlying depression, poor nutrition, social isolation and the compulsive urge to pick at his skin.…”