Trigeminal trophic syndrome (TTS) is a rare condition that results from damage to the central or peripheral branches of the trigeminal nerve. Themost common causes cited in the literature are trigeminal nerve ablation or transaction of the gasserian ganglion (as treatment of trigeminal neuralgia), stroke (specifically the Wallenberg lateral medullary syndrome), acoustic neuromas, postencephalitis, vertebrobasilar insufficiency, astrocytoma, syringobulbia, herpes zoster, and trauma. The first cases of TTS were published independently byWallenberg andLoveman in 1933. TTS is a clinical diagnosis that is characterized by paresthesia and nasal ulcerations, which are caused by repetitive scratching of the skin, in the distribution of the damaged trigeminal nerve. The time of onset varies significantly, ranging from months to decades. It is believed that patients pick or rub at the skin to relieve the irritation caused by the paresthesias, often described as a burning, itching, or crawling sensation. Decreased sensation often accompanies the paresthesias, allowing for severe disfigurement to occur with repetitive manipulation of the area. The repetitive scratching and manipulation results in painless, unilateral, crescent-shaped ulcers that classically involve the nasal ala.