Trigeminal trophic syndrome: an important simulator of discoid cutaneous lupus erythematosus – a case series

Abstract

Trigeminal trophic syndrome occurs secondary to trigeminal nerve injury, leading to anaesthesia and paraesthesia, with consequent vigorous facial skin manipulation and lesion production, simulating other facial diseases such as ulcerative discoid lupus erythematosus, tumours and other artificially produced lesions. Ulceration and destruction of the ala nasi is a typical feature besides scratching end excoriations in the cutaneous segment affected. In this series, we present the features of five patients with trigeminal trophic syndrome, highlighting possible confusion with cutaneous lupus. Differential diagnoses, including discoid lupus erythematosus, are discussed, as well as possible treatment modalities.

Trigeminal Trophic Syndrome: A Comprehensive Review of a Surgical Approach

“…Other less common areas of involvement included the cheek (24%), scalp (10%), and eyelid (6%). The most common causes included trigeminal ablation (30 cases, 27%),3,4,6,9,12,18,20,24,26,27,37,41,44,53-57 stroke (31 cases, 28%),7,9,11,13,14,17,19,21,25,27,28,32,33,35,39,40,47,50,56,58-63 surgical complication (22 cases, 20%),5,12,19,23,27,29,30,34,64-71 herpes zoster (93 cases, 12%),10,15,16,27,36,42,43,49,52,72-74 trauma (4 cases, 4%),12,19,56 meningioma complication (3 cases, 3%) 46,47. The mean duration of symptoms before presentation was 2 years (range: 1 week −28 years) and the mean latency period from initial injury to symptom onset was 5 years (range: 0 days −30 years).…”

“…Other less common areas of involvement included the cheek (24%), scalp (10%), and eyelid (6%). The most common causes included trigeminal ablation (30 cases, 27%), 3,4,6,9,12,18,20,24,26,27,37,41,44,[53][54][55][56][57] stroke (31 cases, 28%), 7,9,11,13,14,17,19,21,25,27,28,32,33,35,39,40,47,50,56,[58][59][60][61][62][63] surgical complication (22 cases, 20%), 5,12,19,23,27,29,30,34,…”

Trigeminal Trophic Syndrome as a Complication of Herpes Zoster Ophthalmicus

“…The characteristic clinical triad of TTS is facial skin ulceration, paresthesia, and hypoesthesia or anesthesia [1][2][3][4][5][6][7]. There are multiple causes for TTS and the most common are iatrogenic such as therapeutic trigeminal nerve ablation.…”

“…There are multiple causes for TTS and the most common are iatrogenic such as therapeutic trigeminal nerve ablation. There are other potential causes including, but not limited to, ischemic medullary or pontine stroke, craniofacial surgery, acoustic neuroma, post-infectious encephalitis, astrocytoma, meningioma, surgical or local trauma, and amyloid deposits in the trigeminal nerve and herpes zoster infection, as is the case for this patient [ 1 - 7 ]. Most ulcers affect the infraorbital nerve distribution.…”