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Unilateral facial ulceration and Horner's syndrome
A M Loftusa, M O McCarronb, R N de Silvab, J Thomsona
a Department
of Dermatology, Glasgow Royal Infirmary, Glasgow
G4 0SF, UK, b Department of Neurology, Institute of
Neurological Sciences, Southern General Hospital,
Glasgow G51 4TF,
UK
Correspondence to: M O McCarron
Accepted 13 May 1998
| The first 150 words of the full text of this article appear below. |
 |
Introduction |
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A 55-year-old diabetic and hypertensive woman presented acutely with vertigo and vomiting. She had right-sided ataxia, horizontal right gaze-evoked nystagmus, and a right miosis. Later, a right ptosis was noted. Temperature and pinprick sensations on the right side of the face and left side of the body were disturbed. Examination of the precordium was normal. Computed tomography of the head showed moderate generalised cerebral atrophy and an old left occipital infarct. There was no evidence of brainstem or cerebellar haemorrhage.
Six months later the patient presented with excoriation and
ulceration affecting the right eyelid, temple and frontal scalp. She
complained of persistent itch in these sites. Swabs from the ulcerated
areas were negative, including on viral culture. She was prescribed
topical 2% fucidic acid / 0.1% betamethasone valerate cream and 1%
ichthammol in zinc ointment, and advised to avoid scratching. Four
years later, however, the same lesions are still noted,
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