Department of Plastic and Reconstructive Surgery, Ramón y Cajal University Hospital, Madrid, Spain.
Department of Plastic and Reconstructive Surgery, Ospedale Policlinico San Martino, Genoa University, Genova, Italy.
J Tissue Viability. 2022 May;31(2):369-371. doi: 10.1016/j.jtv.2022.01.008. Epub 2022 Jan 26.
Trigeminal trophic syndrome is a rare condition characterized by self-inflicted persistent facial ulceration. It is believed to be consequent to central or peripheral insult to trigeminal nerve, which may have taken place even years before the ulcer development. The aggression to the nerve pathway causes dysesthesias in the trigeminal dermatomes that induce a self-mutilating behavior, with repetitive pinching or scratching in order to mitigate the altered sensation. Due to associated skin anesthesia, the patient does not interrupt manipulation of the affected area despite severe skin necrosis. Ulceration typically occurs in the ala nasi and may resemble other more common cutaneous diseases, such as tumors or infections. Given that this condition is not included in our daily clinical practice, the risk is that of a diagnostic delay with devastating functional and esthetic facial consequences. We present the case of a patient with a history of meningioma resection who developed this syndrome and we have reviewed the published literature to provide an update on the etiopathogenesis, diagnosis and treatment of this rare condition.
三叉神经营养综合征是一种罕见的疾病，其特征为自伤性持续性面部溃疡。据信，这是由于三叉神经的中枢或外周损伤所致，这种损伤甚至可能在溃疡发生多年前就已发生。对神经通路的侵犯会导致三叉神经皮节的感觉异常，从而引起自伤行为，反复捏或搔抓以减轻改变的感觉。由于相关的皮肤麻醉，尽管皮肤严重坏死，患者仍不会中断对受影响区域的操作。溃疡通常发生在鼻翼，可能类似于其他更常见的皮肤疾病，如肿瘤或感染。鉴于这种情况不在我们的日常临床实践中，诊断延迟会导致严重的功能和面部美观后果。我们报告了一例脑膜瘤切除术后发生这种综合征的患者，并回顾了已发表的文献，以提供这种罕见疾病的病因、发病机制、诊断和治疗的最新信息。
