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Trigeminal trophic syndrome.

Hedy G Setyadi1, Philip R Cohen, Keith E Schulze

  • 1Baylor College of Medicine, USA.

Southern Medical Journal
|February 3, 2007
PubMed
Summary
This summary is machine-generated.

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Trigeminal trophic syndrome can cause self-induced nasal ulcers, often mistaken for skin cancer. Early diagnosis and preventing self-inflicted injury are key to managing these chronic nasal ulcerations.

Area of Science:

  • Dermatology
  • Neurology

Background:

  • Trigeminal trophic syndrome (TTS) is an uncommon but important cause of chronic nasal ulcerations.
  • It typically affects older women post-trigeminal neuralgia treatment, presenting with ulcers on the nasal ala and paranasal areas.
  • Self-induced nasal ulcers can be misdiagnosed, highlighting the need for awareness among healthcare providers.

Observation:

  • A clinical case is presented of a man with a self-induced nasal ulcer due to TTS, initially suspected as skin cancer.
  • The patient's self-inflicted injury led to ulceration, emphasizing the behavioral component of the condition.

Findings:

  • Nasal ulcerations necessitate a thorough differential diagnosis, including factitial disorders, granulomatous conditions, infections, malignancy, and pyoderma gangrenosum.
  • A lesional biopsy is crucial to exclude other potential diagnoses when TTS is suspected.

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  • TTS ulcers are characterized by self-inflicted injury, often stemming from sensory disturbances related to trigeminal nerve pathways.

    • Implications:

    • Prompt diagnosis of TTS is vital to prevent further self-inflicted injury and misdiagnosis.
    • Management focuses on preventing digital manipulation of the ulcer through occlusion or psychotropic medication.
    • Psychiatric and pharmacologic interventions are recommended to manage habitual self-injury before considering surgical options.