Trigeminal trophic syndrome from stroke: an under-recognized central neuropathic itch syndrome.
Trigeminal trophic syndrome (TTS) is the historic name for neuropathic self-induced facial ulceration from abnormal sensory symptoms leading to uncontrolled scratching. Anatomic co-localization of sensory loss (numbness) plus neuropathic itch and pain permits painless scratching. If the itch is severe, some patients will scratch to the point of causing self-injury. Patients may be unaware or may conceal the fact that their lesions are self-induced and thus the diagnosis presents a clinical challenge. Many cases remain undiagnosed, leading to unnecessary and ineffective tests, procedures, and prescribing. We document a patient with a central cause of TTS - multiple cerebral vascular accidents - and summarize the presentation, pathogenesis, and treatment options.
Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27104, USA.
Ashley R
AR
Curtis
Anne L
AL
Oaklander
Annette
A
Johnson
Gil
G
Yosipovitch
D005260:Female; D006801:Humans; D008875:Middle Aged; D011537:Pruritus / Q000209:etiology*; D012883:Skin Ulcer / Q000209:etiology; D020521:Stroke / Q000150:complications*; D013577:Syndrome; D020433:Trigeminal Nerve Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy