Chondrodermatitis Nodularis Helicis in a 40-Year-Old Man

February 15, 2012

A 40-year-old man complains about a severely painful bump on his ear. He has trouble sleeping on that side due to the pain that occurs when he lays his head (and ear) down on the pillow. What is his condition?

A 40-year-old man complains about a severely painful bump on his ear. He has trouble sleeping on that side because of the pain that occurs when he lays his head (and ear) down on the pillow. He has not had skin cancer and does not wear a helmet for any reason.

Key point: The presence of extremely tender and spontaneously painful nodules on the helix of the ear is typical for chondrodermatitis nodularis helicis. This is an idiopathic inflammatory condition of the cartilage that ultimately affects overlying skin. The dome-shaped, flesh-colored to pink nodule typically has a central crust-filled crater.

Treatment: Application of potent topical corticosteroids or intralesional injection of diluted triamcinolone acetonide suspension is often curative. Surgical removal or carbon dioxide laser lesion ablation may also be entertained as treatment options.

Note: This lesion must be differentiated from basal cell and squamous cell carcinoma and gouty tophi or calcinosis cutis-all of which may involve the outer portion of the ear.