chondrodermatitis nodularis
Last reviewed 01/2018
- this is a chronic inflammation of the skin and cartilage occuring on the
helix of the auricle
- presentation is usually with a tender papule
- the most protuberant part ear is affected which is generally the helix in men and the antihelix in women
- there is generally a small papule of about 0.5cm in diameter - the lesion may have a small ulcer in the middle, often hidden by a small scale or crust. The papule may surrounded by erythema
- multiple lesions may occur
- presentation is usually with a tender papule
- more common in patients who habitually sleep on one side at night - contact pressure between the head and the pillow is thought to be important in the aetiology of this condition. Hearing aids may cause chondrodermatitis as a result of pressure from one of the plastic components
- differential diagnosis includes:
- early basal cell carcinoma but a BCC is generally painless - tend to occur on the back of the ear or in the greasier conchal skin
- squamous cell carcinoma and solar keratoses - tend to occur on the rim of the ear or the upper part of the pinna, but not at the free edge of the cartilage
- rarer discrete nodules on the ear include atypical fibroxanthoma (generally
diagnosed as squamous cell carcinoma clinically) and melanoma (often nodular
in type at this site)
- management:
- generally requires specialist review regarding confirmation of diagnosis and treatment plan
- treatment options for chondrodermatitis nodularis include:
- no intervention/pressure relief
- chondrodermatitis nodularis helicus is benign and so only those who suffer pain require treatment (1)
- patients should be encouraged to avoid sleeping on the affected side and use foam pillows eg a Dunlopillow
- alternatively patients can cut a hole out of foam, rubber or a bath sponge to fit around the ear at night and hold in place with an elastic headband
- patients should wear a warm hat over the ears when outside in
the cold
- topical treatment
- options include lignocaine gel applied before retiring to bed
and potent topical steroid ointments
- steroid injections into the nodule may lead to prolonged improvement
in about one third of patients (1)
- surgery
- excision of the papule and a sliver of the cartilage beneath and adjacent
- but recurrence rates of up to 30% have been reported (2)
- no intervention/pressure relief
Click here for example image of this condition
Reference:
- Dermatology in Practice 2004; 12 (2): 28-30.
- Primary Care Dermatological Society. Chondrodermatitis nodularis helicis (Accessed 29/7/14)