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Chondrodermatitis Nodularis Helicis

Clinical Case

Case 1

  • 70-year-old healthy man
  • No significant past medical history
  • Review of systems is noncontributory
  • Social history is noncontributory; does not smoke or drink alcohol
  • Presents for management of 4-month painful erosion on the helical rim of his left ear

Initial evaluation

  • Healthy appearing male
  • Tender mildly erythematous dome-shaped papule with central ulceration and crusting
  • Diagnosis: chondrodermatitis nodularis helicis
  • Recommend pressure-offloading “doughnut” ear prosthesis, softer pillow, sleeping on the opposite side, and avoiding use of telephone pressing up against that ear or the use of headphones
  • Follow-up in two to three months

Follow-up evaluation

  • Patient notes some relief but the lesion persists
  • Biopsy to exclude non-melanoma skin cancer: pathology consistent with chondrodermatitis nodularis helicis
  • Intralesional triamcinolone 5 mg/cc is injected into the site
  • Follow-up if fails to resolve
  • Additional treatment options include: topical nitroglycerin, surgical therapy