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The Cutting Edge
August 18, 2008

Successful Treatment of Trigeminal Trophic Syndrome in a 6-Year-Old Boy With Negative Pressure Wound Therapy

Author Affiliations
 

MICHAEL P.HEFFERNANMDCHRISTIEAMMIRATIMD

Arch Dermatol. 2008;144(8):984-986. doi:10.1001/archderm.144.8.984

A 6-year-old boy presented with 4 areas of ulceration on the right side of his face and scalp. Medical history was significant for a right-sided exophytic juvenile pilocystic astrocytoma that was diagnosed at 5 years of age after he developed a persistent head tilt to the left. Postoperative scans disclosed minimal residual tumor in the lateral brainstem.

Within a year, the patient noticed the absence of sensation on his right cheek and lip and no taste on the right side of his tongue. He began drooling from the right side of his mouth, and his parents noticed that his smile was uneven as well. A residual tumor had grown to impinge on cranial nerves V and VII, and the patient underwent a second craniotomy in an attempt to restore function. The entire tumor was removed with this second surgery, but 3 months later, the patient's right eye became edematous and an absence of tear production was discovered. Ocular lubricant was prescribed, and the eye was patched daily for 2 weeks. Within a short time, the skin on his right forehead began to break down owing to the adhesive bandage used for his eye protection. He then developed a similar ulceration on his right nasal ala and at other locations that were not occluded with tape or dressings (Figure 1).

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