Unilateral facial erythema following food chewing

Abstract

A 3 yrs old girl presented with unilateral facial erythema and sweating after gustatory stimuli. She had history of mycoplasma and Brucella infection. She developed left facial palsy that has been resolved. She received antibiotics and corticosteroids. CT scan and MRI brain were normal. Interestingly, the child fulfill the clinical diagnosis of Frey syndrome. Frey's syndrome is characterized by unilateral sweating and flushing of the skin in the area of the parotid gland, occurring during meal, or on salivary stimulation. It is a common complication following surgery/injury in the parotid gland region/temporomandibular joint surgery; however, very few cases had been reported following herpetic infection. The condition may be misdiagnosed as contact dermatitis or food allergy, but these can be excluded by the normal skin texture and typical unilateral distribution on the pre-auricular area and cheek. The diagnosis is made on clinical grounds, and further testing is not needed. It is important for the clinician to recognize its unusual symptoms as early as possible to prevent its potential negative social and psychological effect on the patient. Mycoplasma infection, as in this case, is a rare cause of Frey’s syndrome. Here we highlight the importance of considering Frey syndrome in these cases as Patients can be reassured of the benign nature of the condition and that symptoms usually resolve spontaneously in children.