Kim Jeeyoon, Rha Eun Young, Shin Jongweon
Department of Plastic and Reconstructive Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
J Craniofac Surg. 2025 Jun 23. doi: 10.1097/SCS.0000000000011603.
Autonomic denervative dermatitis (ADD) is a rare skin condition caused by autonomic nerve injury, often after surgery. It typically presents as erythematous or excoriated lesions in areas with sensory loss. While cases in the lower limbs are documented, facial involvement after mandibuloplasty has not been reported. The authors describe a 27-year-old woman who developed ADD 1 year after angle-body reduction mandibuloplasty. She presented with pruritic, erythematous papules on the chin and sensory deficits. The lesions resolved spontaneously, leaving scarring and contour irregularities. Diagnosis was based on clinical history and exclusion of other conditions such as contact dermatitis and seborrheic dermatitis. Autonomic denervative dermatitis arises from sudomotor dysfunction and immune dysregulation due to autonomic nerve damage. Surgeons should be aware of this potential complication, especially involving the mandibular canal. Early recognition and treatment with emollients, corticosteroids, and antihistamines may prevent permanent sequelae. This case underscores the need for awareness to avoid underdiagnosis.
自主神经失神经性皮炎（ADD）是一种由自主神经损伤引起的罕见皮肤病，通常发生在手术后。它通常表现为感觉丧失区域的红斑或擦伤性病变。虽然下肢病例有文献记载，但下颌整形术后面部受累尚未见报道。作者描述了一名27岁女性，在进行下颌角体缩小整形术后1年发生了ADD。她的下巴出现瘙痒性红斑丘疹和感觉障碍。病变自行消退，留下瘢痕和轮廓不规则。诊断基于临床病史并排除其他疾病，如接触性皮炎和脂溢性皮炎。自主神经失神经性皮炎源于自主神经损伤导致的汗腺功能障碍和免疫失调。外科医生应意识到这种潜在并发症，尤其是涉及下颌管的情况。早期识别并用润肤剂、皮质类固醇和抗组胺药治疗可能预防永久性后遗症。该病例强调了提高认识以避免漏诊的必要性。
