Trigeminal trophic syndrome is a rare dermatological manifestation of abnormal sensations in areas innervated by trigeminal nerve. The area most commonly affected is ala nasi. It may extend to cheeks and lips. The injury to trigeminal nerve causes aberrant sensations such as tingling and numbness which provokes urge to scratch excessively, resulting in ulcers. The mainstay of management of trigeminal trophic syndrome is educating the patient regarding the nature of condition. Pharmacological therapy includes carbamazepine, chlorpromazine, and amitriptyline, however, their efficiency in reducing paresthesia is not proven. Other advanced options may include transcutaneous electrical stimulation, radiotherapy, and stellate ganglionectomy. Reference: https://dermnetnz.org/topics/trigeminal-trophic-syndrome/ Image via https://asps.confex.com/asps/2005src/techprogram/paper_7744.htm
So the damages to this patient's face are self-inflicted caused by excessive scratching?!