Medscape is available in 5 Language Editions – Choose your Edition here.


Pseudocyst of the Auricle Clinical Presentation

  • Author: William P Baugh, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Nov 12, 2014


A pseudocyst manifests as a painless swelling on the lateral or anterior surface of the pinna, developing over a period of 4-12 weeks. A history of trauma may accompany the clinical history, including rubbing, ear pulling, sleeping on hard pillows, or wearing of a motorcycle helmet or earphones. It has also been associated with cases of pruritic skin or systemic diseases including atopic dermatitis and lymphomas.[7, 8]



A pseudocyst is a noninflammatory, asymptomatic swelling on the lateral or anterior surface of the pinna, usually in the scaphoid or triangular fossa. They range from 1-5 cm in diameter and contain clear or yellowish viscous fluid, with a consistency similar to that of olive oil. Note the image below.

Asymptomatic nodule on the left ear. Asymptomatic nodule on the left ear.


The etiology for pseudocysts of the auricle is unknown, but several pathogenic mechanisms have been proposed, including chronic low-grade trauma and spontaneous development.[9] Some have suggested that a minor defect in auricular embryogenesis can also contribute to pseudocyst formation. This defect may cause the formation of residual tissue planes within the auricular cartilage. When subjected to repeated minor trauma or mechanical stress, these tissue planes may open, forming a pseudocyst. The auricular cartilage in particular may be more susceptible to traumatic insult because of its lack of connective tissue overlying the cartilage with firm adherence to the skin.[10]

Consistent with the proposed mechanism, atopic dermatitis with accompanying facial and ear involvement may be a predisposing condition for pseudocyst formation.[7, 11] Although the incidence of pseudocysts in patients with atopic dermatitis appears to be low, these patients have an earlier occurrence of the condition and a greater incidence of bilateral lesions compared with the general population.

Pseudocyst has also been reported in a patient with intense pruritus who was later diagnosed with lymphoma.[8] After chemotherapy for the lymphoma, the pruritus improved with spontaneous reduction in the volume of the pseudocyst. The authors proposed that the trauma from scratching and rubbing of the ears was the major exacerbating cause of the pseudocyst.

Contributor Information and Disclosures

William P Baugh, MD Assistant Clinical Professor of Dermatology, Western University of Health Sciences; Medical Director, Full Spectrum Dermatology; Consulting Staff, Department of Dermatology, St Jude Medical Center

William P Baugh, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Laser Medicine and Surgery, Christian Medical and Dental Associations

Disclosure: Nothing to disclose.


Cynthia L Chen, DO, DO Intern, Pacific Hospital of Long Beach, California

Cynthia L Chen, DO, DO is a member of the following medical societies: American Osteopathic Association, California Medical Association, American Osteopathic College of Dermatology, Los Angeles County Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: American Medical Association, Alpha Omega Alpha, Association of Military Dermatologists, American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Phi Beta Kappa

Disclosure: Nothing to disclose.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Kelly M Cordoro, MD Assistant Professor of Clinical Dermatology and Pediatrics, Department of Dermatology, University of California, San Francisco School of Medicine

Kelly M Cordoro, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Medical Society of Virginia, Society for Pediatric Dermatology, Women's Dermatologic Society, Association of Professors of Dermatology, National Psoriasis Foundation, Dermatology Foundation

Disclosure: Nothing to disclose.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Mark L. Welch, MD, and Hon Pak, MD, to the development and writing of this article.

  1. Engel D. Pseudocysts of the auricle in Chinese. Arch Otolaryngol. 1966 Mar. 83(3):197-202. [Medline].

  2. Miyamoto H, Okajima M, Takahashi I. Lactate dehydrogenase isozymes in and intralesional steroid injection therapy for pseudocyst of the auricle. Int J Dermatol. 2001 Jun. 40(6):380-4. [Medline].

  3. Chen PP, Tsai SM, Wang HM, Wang LF, Chien CY, Chang NC, et al. Lactate dehydrogenase isoenzyme patterns in auricular pseudocyst fluid. J Laryngol Otol. 2013 May. 127(5):479-82. [Medline].

  4. Kopera D, Soyer HP, Smolle J, Kerl H. "Pseudocyst of the auricle", othematoma and otoseroma: three faces of the same coin?. Eur J Dermatol. 2000 Aug. 10(6):451-4. [Medline].

  5. Tan BY, Hsu PP. Auricular pseudocyst in the tropics: a multi-racial Singapore experience. J Laryngol Otol. 2004 Mar. 118(3):185-8. [Medline].

  6. Kanotra SP, Lateef M. Pseudocyst of pinna: a recurrence-free approach. Am J Otolaryngol. 2009 Mar-Apr. 30(2):73-9. [Medline].

  7. Ng W, Kikuchi Y, Chen X, Hira K, Ogawa H, Ikeda S. Pseudocysts of the auricle in a young adult with facial and ear atopic dermatitis. J Am Acad Dermatol. 2007 May. 56(5):858-61. [Medline].

  8. Pereira FC, Chinelli PA, Takahashi MD, Nico MM. Bilateral pseudocyst of the auricle in a man with pruritus secondary to lymphoma. Int J Dermatol. 2003 Oct. 42(10):818-21. [Medline].

  9. Stankevice D, Nielsen KO. [Two cases of auricular pseudocyst]. Ugeskr Laeger. 2009 Mar 9. 171(11):907. [Medline].

  10. Glamb R, Kim R. Pseudocyst of the auricle. J Am Acad Dermatol. 1984 Jul. 11(1):58-63. [Medline].

  11. Devlin J, Harrison CJ, Whitby DJ, David TJ. Cartilaginous pseudocyst of the external auricle in children with atopic eczema. Br J Dermatol. 1990 May. 122(5):699-704. [Medline].

  12. Tuncer S, Basterzi Y, Yavuzer R. Recurrent auricular pseudocyst: a new treatment recommendation with curettage and fibrin glue. Dermatol Surg. 2003 Oct. 29(10):1080-3. [Medline].

  13. Lim CM, Goh YH, Chao SS, Lim LH, Lim L. Pseudocyst of the auricle: a histologic perspective. Laryngoscope. 2004 Jul. 114(7):1281-4. [Medline].

  14. Lazar RH, Heffner DK, Hughes GB, Hyams VK. Pseudocyst of the auricle: a review of 21 cases. Otolaryngol Head Neck Surg. 1986 Mar. 94(3):360-1. [Medline].

  15. Hoffmann TJ, Richardson TF, Jacobs RJ, Torres A. Pseudocyst of the auricle. J Dermatol Surg Oncol. 1993 Mar. 19(3):259-62. [Medline].

  16. Job A, Raman R. Medical management of pseudocyst of the auricle. J Laryngol Otol. 1992 Feb. 106(2):159-61. [Medline].

  17. Miyamoto H, Oida M, Onuma S, Uchiyama M. Steroid injection therapy for pseudocyst of the auricle. Acta Derm Venereol. 1994 Mar. 74(2):140-2. [Medline].

  18. Kim TY, Kim DH, Yoon MS. Treatment of a recurrent auricular pseudocyst with intralesional steroid injection and clip compression dressing. Dermatol Surg. 2009 Feb. 35(2):245-7. [Medline].

  19. Patigaroo SA, Mehfooz N, Patigaroo FA, Kirmani MH, Waheed A, Bhat S. Clinical characteristics and comparative study of different modalities of treatment of pseudocyst pinna. Eur Arch Otorhinolaryngol. 2011 Oct 29. [Medline].

  20. Lim CM, Goh YH, Chao SS, Lynne L. Pseudocyst of the auricle. Laryngoscope. 2002 Nov. 112(11):2033-6. [Medline].

  21. Khan NA, Ul Islam M, Ur Rehman A, Ahmad S. Pseudocyst of pinna and its treatment with surgical deroofing: an experience at tertiary hospitals. J Surg Tech Case Rep. 2013 Jul. 5(2):72-7. [Medline]. [Full Text].

  22. Salgado CJ, Hardy JE, Mardini S, Dockery JM, Matthews MS. Treatment of auricular pseudocyst with aspiration and local pressure. J Plast Reconstr Aesthet Surg. 2006. 59(12):1450-2. [Medline].

  23. Oyama N, Satoh M, Iwatsuki K, Kaneko F. Treatment of recurrent auricle pseudocyst with intralesional injection of minocycline: a report of two cases. J Am Acad Dermatol. 2001 Oct. 45(4):554-6. [Medline].

  24. Cohen PR, Katz BE. Pseudocyst of the auricle: successful treatment with intracartilaginous trichloroacetic acid and button bolsters. J Dermatol Surg Oncol. 1991 Mar. 17(3):255-8. [Medline].

  25. AlGhamdi KM, AlEnazi MM. Versatile punch surgery. J Cutan Med Surg. 2011 Mar-Apr. 15(2):87-96. [Medline].

  26. Han A, Li LJ, Mirmirani P. Successful treatment of auricular pseudocyst using a surgical bolster: a case report and review of the literature. Cutis. 2006 Feb. 77(2):102-4. [Medline].

  27. Cohen PR. Successful treatment of auricular pseudocyst using a surgical bolster. Cutis. 2007 Oct. 80(4):274. [Medline].

  28. Shan Y, Xu J, Cai C, Wang S, Zhang H. Novel Modified Surgical Treatment of Auricular Pseudocyst Using Plastic Sheet Compression. Otolaryngol Head Neck Surg. 2014 Sep 12. [Medline].

Asymptomatic nodule on the left ear.
Low magnification of this pseudocyst reveals a mucin-containing cystic cavity.
Table. Comparison of Characteristics of 4 Auricular Conditions.
  Pseudocyst of the auricle Chondrodermatitis chronica helices Relapsing polychondritis Subperichondrial hematoma
Swelling Localized Localized Diffuse Localized
Skin involvement Rare Yes, crusting/ulceration Yes, erythematous Rare
Pain Rare Common (from ulceration) Common (extremely tender) Common
Systemic Symptoms No No Yes (involvement of other cartilage) No
Histology racartilaginous, cystic defect, granulation tissue Subperichondrial granulation tissue, cystic dilatation rare Acute inflammable cells seen; antibody deposition on basement membrane during immunofluorescence Inflammatory cells with degraded blood products
Adapted from Lim CM, et al. “Pseudocyst of the Auricle.” 2002.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.