Trigeminal trophic syndrome

Trigeminal trophic syndrome is a rare disease caused by the interruption of peripheral or central sensory pathways of the trigeminal nerve. A slowly enlarging, uninflamed ulcer can occur in the area that has had trigeminal nerve damage; including but not limited to the cheek beside the ala nasi.

Signs and symptoms
The most common complaints are feelings of picking, rubbing, or scratching in the afflicted areas. A nonhealing ulcer is present in most patients. The ala nasi is frequently affected by a recognizable, painless, sickle-shaped lesion with a well-defined margin. The ulcers are incredibly persistent once they start.

Causes
Trigeminal trophic syndrome can present with the following conditions and diseases: syphilis, amyloid deposits in the CNS and trigeminal nerve, trauma, craniotomy, tumor, Wallenberg syndrome (stroke/vascular insufficiency), herpes zoster, herpes simplex, syphilis, and neurological complications from birth trauma or it can be idiopathic.

Treatment
Treating trigeminal trophic syndrome is a difficult task. Among the options are transcutaneous nerve stimulation, protective dressings, behavioral modification, medication intervention, and surgical repair; however, none of these have been proven to be consistently effective.

Epidemiology
Sixty cases were reported from 1982 to 2002. Trigeminal trophic syndrome is more common in women as compared to men.