01-04-2012 | Case Report
Trigeminal Trophic Syndrome from Stroke
An Under-Recognized Central Neuropathic Itch Syndrome
Published in: American Journal of Clinical Dermatology | Issue 2/2012
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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.