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Author Spotlight: Exploring Peripheral Mechanisms of Neuropathic Pain in Trigeminal Nerve Injury
Published on: February 9, 2024
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Trigeminal trophic syndrome with histopathologic correlation
Lindsey B Dolohanty1, Steven J Richardson, David N Herrmann
1990 South Ave, Ste 206, Rochester, NY 14620, USA. lindsey_dolohanty@urmc.rochester.edu.
Cutis
|April 7, 2015
Summary
Trigeminal trophic syndrome (TTS) can cause severe itching and pain, even without nerve damage in the skin. Skin biopsy in this case revealed no innervation despite reported symptoms, highlighting a unique presentation.
Area of Science:
- Neurology
- Dermatology
- Pathology
Background:
- Trigeminal trophic syndrome (TTS) is a rare condition characterized by facial ulcerations.
- It is often associated with trigeminal nerve damage, commonly from herpes zoster (HZ).
- Symptoms can include chronic pain and intractable itching.
Observation:
- A 49-year-old woman presented with symptoms of TTS affecting the V1 branch of the trigeminal nerve.
- She reported intractable itching and chronic pain.
- Skin biopsy histology of the affected scalp showed a complete absence of neuronal innervation.
Findings:
- The case highlights an uncommon presentation of TTS with severe sensory symptoms despite a lack of detectable nerve fibers in the affected skin.
- Histological findings correlated with the V1 branch of the trigeminal nerve involvement secondary to herpes zoster.
- This suggests a complex mechanism underlying the symptoms in TTS.
Implications:
- The findings challenge the traditional understanding of TTS pathophysiology, suggesting that symptoms may arise from mechanisms other than direct peripheral nerve damage.
- This case underscores the importance of detailed histological examination in diagnosing and understanding TTS.
- Further research is needed to elucidate the neurobiological basis of itching and pain in the absence of innervation in TTS and postherpetic neuralgia.
