Đorđević Betetto Laura, Bajuk Vid
Department of Dermatovenereology, University Medical Center Ljubljana, Ljubljana, Slovenia.
Acta Dermatovenerol Alp Pannonica Adriat. 2023 Mar;32(1):31-35.
Trigeminal trophic syndrome (TTS) is an uncommon and relatively unknown cause of facial ulceration that occurs after damage to the trigeminal nerve. It characteristically involves non-healing facial ulceration(s) with accompanying anesthesia, paresthesia, and dysesthesia along the distribution of a trigeminal dermatome. The ulcerations are believed to be self-induced in response to paresthesia. The disease is most common in middle-aged women, manifesting as a unilateral crescent-shaped ulceration on the ala nasi, with sparing of the nasal tip. The diagnosis is clinical and mostly based on exclusion of other possible causes of facial ulcerations, with emphasis on neoplasms, infection-associated vasculitis, and factitial disorders. There are no specific histological or laboratory signs. There is no standard treatment protocol; however, a number of different successful strategies have been reported, including pharmaceutical and surgical interventions, transcutaneous nerve stimulation, and simple occlusion dressings. Due to the self-inflicted nature of this disorder, the cornerstone of management is patient education with behavioral modification. Here, we report a case of TTS following herpes zoster ophthalmicus and review the current literature on this subject.
三叉神经营养综合征（TTS）是一种罕见且相对不为人知的面部溃疡病因，发生于三叉神经受损后。其特征为面部溃疡不愈合，并伴有三叉神经皮节分布区域的感觉缺失、感觉异常和感觉迟钝。溃疡被认为是对感觉异常的自我诱发反应。该疾病在中年女性中最为常见，表现为鼻翼单侧新月形溃疡，鼻尖不受累。诊断主要依靠临床，且大多基于排除其他可能导致面部溃疡的病因，重点是肿瘤、感染相关血管炎和人为性疾病。不存在特异性的组织学或实验室指标。目前尚无标准治疗方案；然而，已报道了多种不同的成功治疗策略，包括药物和手术干预、经皮神经刺激以及单纯的封闭敷料。由于该疾病的自我造成性质，管理的基石是对患者进行行为矫正教育。在此，我们报告一例带状疱疹性眼炎后发生的TTS病例，并综述关于该主题的当前文献。
