1) Rarely, such injury can be complicated by the development of a triad of anesthesia, paresthesias, and crescentic ala nasi ulceration known as the trigeminal trophic syndrome (TTS).
Trigeminal trophic syndrome mimicking Wegener's granulomatosis.
Although trigeminal trophic syndrome is an uncommon cause of chronic ulcers, healthcare providers should consider the possibility of this disorder when encountering a patient with nasal ulcerations.
Nasal ulceration may be caused by several conditions, including trigeminal trophic syndrome (Table 1).
Correlating the patient's history of dementia and stroke on the ipsilateral side of the nasal ulcer, the clinical features of the lesion, and the pathologic findings, the diagnosis of a self-induced nasal ulceration resulting from trigeminal trophic syndrome was made.
Trigeminal trophic syndrome is most commonly unilateral, (6) with the right side involved almost twice as often as the left.
Trigeminal trophic syndrome is sometimes described as a triad of trigeminal anesthesia, facial paresthesia, and crescentic nasal alar ulceration.
The histologic findings of trigeminal trophic syndrome are not pathognomonic.
It may be difficult to differentiate between trigeminal trophic syndrome and factitial disorders when a patient presents with a self-induced nasal ulcer.
The pathogenesis of trigeminal trophic syndrome involves self-manipulation of the skin.
In 1985, Harper (19) noted that mental abnormality was described in the reports of 19% of the 31 trigeminal trophic syndrome patients he could find in the literature.