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February 1967

Giant Ulcer of the Face Following Surgery for Trigeminal Neuralgia

Author Affiliations

St Louis

From the Division of Dermatology, Washington University, St. Louis.

Arch Intern Med. 1967;119(2):218-222. doi:10.1001/archinte.1967.00290200142017

TRIGEMINAL neuralgia (tic douloureux) is one of the commoner forms of neuralgia and one which frequently necessitates surgical treatment. Many patients develop complications following surgery. The most common complication is herpes simplex, a significant number of patients develop neuroparalytic keratitis, and a rare patient develops neurotrophic ulceration of the face, a complication which is not well known and, therefore, is frequently misdiagnosed and consequently mismanaged.

This paper is a report of a patient who developed a giant ulcer of the side of the face following surgical ablation of the homolateral trigeminal nerve.

Report of Case  An 83-year-old white woman was first admitted to the Barnard Free Skin and Cancer Hospital in July 1965 with a giant ulcer of the right cheek. The ulcer began eight months before on the right side of the upper lip immediately above the angle of the mouth. A clinical diagnosis of "keratoses of the

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