Unilateral Gustatory Flushing: A Variant of Frey’s Syndrome?

We report two cases of unilateral gustatory flushing presenting in infancy. This is considered to be a variant of Frey’s syndrome, whereby in children, aberrant sweating is often absent. It occurs as a result of damage, either following perinatal birth trauma or infection. Misdirected regeneration of the parasympathetic fibres of the auriculotemporal nerve results in localised erythema occurring in a fixed distribution. In children, this condition is harmless, spontaneous resolution has been reported and no treatment is required. However, more recently botulinum toxin injections have been proposed for adolescents in whom this may be socially distressing. experienced left sided facial erythema occurring within minutes of eating. There was no associated sweating or any other neurological signs. Relevant obstetric history included severe maternal varicella zoster virus (VZV) infection at 21 weeks gestation. Delivery was induced at 38 weeks, because of maternal diabetes. The final stage of labour was rapid and the child was born with the cord around its neck, subsequently developing marked facial bruising and sub-conjunctival haemorrhage. The child was otherwise healthy. On examination, there were multiple oval atrophic scars on the trunk and lower limbs. Upon eating, an intense macular erythema was once again provoked by chewing of any foods occurring in a fixed distribution on the left cheek, lasting for up to an hour (Figure 2). A lesional skin biopsy of one of the scars was unremarkable suggesting Figure 1: Unilateral erythema in the distribution of the auriculotemporal nerve upon eating gingerbread biscuits in a 4-year-old girl. Citation: Matin RN, Esdaile B, de Sica Chapman A, Ross J, Grabczynska S (2013) Unilateral Gustatory Flushing: A Variant of Frey’s Syndrome? J Clin Exp Dermatol Res S6: 007. doi:10.4172/2155-9554.S6-007