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May 2012

Unilateral Facial Ulceration—Quiz Case

Author Affiliations

Departments of Dermatology (Drs Gavrilova, Martin-Gorgojo, Ruiz-Domenech, and Jorda-Cuevas), Neurology (Dr Alonso-Salvador), and Anatomy Pathology (Dr Gomez-Mateo), Clinical University Hospital of Valencia, Valencia, Spain

Arch Dermatol. 2012;148(5):641-646. doi:10.1001/archdermatol.2012.151a

A 67-year-old white woman presented with a 5-year history of several asymptomatic facial ulcers. Her medical history included hypertension and ischemic stroke, which had occurred 6 years earlier. She complained of an uncomfortable sensation in the affected areas, which caused her to pick at and scratch them frequently.

Cutaneous examination demonstrated multiple ulcers, all strictly limited to the left side of the face (Figure 1). Each ulcer showed well-defined borders with irregular outlines. Neurologic examination revealed no abnormalities other than mild paresthesias on the left side of the face. Histologic analysis was performed with hematoxylin-eosin staining (Figure 2 and Figure 3).

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