A 47-year-old woman presented with a 1.0 x 0.5 cm ulcer in the left nasal ala. One month earlier, she suffered a medullary ischemic stroke and developed left facial paresthesia and anesthesia. A punch biopsy revealed ulceration, dermal fibrosis, and a neutrophilic infiltrate. Tissue cultures were negative. A diagnosis of trigeminal trophic syndrome (TTS) was made.

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