Figure 3: Neurotrophic ulceration at the right nasal alar of a 69 years old woman with vascular dementia, paraparesis, facial paralysis on left side and trigeminal neuropathia on right side. The lesion was decided for biopsy to exclude basal cell carcinoma. By observation of the patient habitual manipulations at the nasal site using the left hand were detected. After application of a splint to the left arm the lesion healed almost completely.