Volume 28, Issue 2 pp. 186-190

Nummular headache with trophic changes inside the painful area

JA Pareja

Corresponding Author

JA Pareja

Departments of Neurology,

Laboratory of Esthesiology, Faculty of Health Sciences, Rey Juan Carlos University. Alcorcón, Madrid, Spain

Juan A. Pareja, Fundación Hospital Alcorcón, Servicio de Neurología, Avda. Budapest s/n, 28922 Alcorcón, Madrid, Spain. E-mail [email protected]Search for more papers by this author
ML Cuadrado

ML Cuadrado

Departments of Neurology,

Laboratory of Esthesiology, Faculty of Health Sciences, Rey Juan Carlos University. Alcorcón, Madrid, Spain

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C Fernández-de-las Peñas

C Fernández-de-las Peñas

Laboratory of Esthesiology, Faculty of Health Sciences, Rey Juan Carlos University. Alcorcón, Madrid, Spain

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C Nieto

C Nieto

Anaesthesiology,

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M SolsF Pinedo

F Pinedo

Pathology, Fundación Hospital Alcorcón and

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First published: 09 January 2008
Citations: 13

Abstract

Nummular headache (NH) is a primary disorder characterized by chronic pain that is exclusively felt in a small area of the head surface. We describe five patients with circumscribed head pain and sensory dysfunction consistent with NH, who in addition developed colocalized trophic changes. All of them had a round or oval patch of skin depression (1–2 cm in diameter) inside of the painful area (2–4.5 cm in diameter). Three of them also showed hair loss, reddish colour, and local increased temperature. Skin biopsies were performed in three patients, and were not specific for any particular dermatological disease. Local trophic changes may be a clinical feature of NH. Together with pain and sensory disturbances, they could represent a restricted form of complex regional pain syndrome. This should be taken as a possible evolution of the underlying morbid process of NH.

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