Facial solitary morphea profunda presenting with painful trigeminal neuropathy: A case report

Author:

Moreno-Ajona David1ORCID,Moreno-Artero Ester2,García de Eulate María Reyes3,Irimia Pablo1,España Agustín2

Affiliation:

1. Department of Neurology, Clínica Universidad de Navarra, Pamplona, Spain

2. Department of Dermatology, Clínica Universidad de Navarra, Pamplona, Spain

3. Department of Radiology, Clínica Universidad de Navarra, Pamplona, Spain

Abstract

Background Localized facial scleroderma usually presents as frontal linear morphea or progressive hemifacial atrophy. Only isolated cases of trigeminal painful neuropathy have been described. Case report A 43-year-old woman developed an oval lesion on the right cheek. After 1 year, she noticed constant “pulling” pain and episodes of lancinating pain, both spontaneous and triggered by chewing and cold drinks. She was diagnosed with solitary morphea profunda and CT scan, ultrasonography, cranial MRI and biopsy were completed. Methylprednisolone (1 gr/day for 3 days) was prescribed. For pain, gabapentin, oxcarbazepine, amitryptiline, pregabalin and eslicarbacepine were all ineffective. A capsaicin patch was placed with prolonged benefit. Later on, the pain slightly worsened; occipital blockade was effective and methotrexate was recommended. Conclusion This is the first case of solitary morphea profunda associated with painful trigeminal neuropathy. Treatment should include immunosuppressants and treatment of neuropathic pain, in which local therapies seem particularly beneficial.

Publisher

SAGE Publications

Subject

Neurology (clinical),General Medicine

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Tocilizumab for refractory post‐COVID‐19 pansclerotic morphea;Journal of the European Academy of Dermatology and Venereology;2023-12-11

2. Capsaicin;Reactions Weekly;2019-05

3. Nummular Headache: 2 Cases With Good Beta Blocker Responses and a Narrative Review;Headache: The Journal of Head and Face Pain;2019-03-14

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