Multiple factitious hemifacial lesions in Wallenberg syndrome

Abstract

We report on a 46-year-old man who presented with an indolent ulcer on his left nasal ala that had appeared about two weeks earlier. His relevant past medical history included a brainstem infarction with ischemia of the left cerebellar hemisphere, which had occurred three months earlier. Moreover, he was status post successful chemotherapy for Hodgkin's disease one year before. The patient had also been diagnosed with a borderline personality disorder, but was not taking any medication.Clinical examination revealed a deep, sharply demarcated crusted ulcer on his left nasal ala (Figure 1). The borders of the ulcer were not raised, and there was moderate surrounding erythema. Confined to the left side of his face, there None.