History
The classic presentation of chondrodermatitis nodularis chronica helicis (CNH) is a middle-aged to elderly man with a spontaneously appearing painful nodule on the helix or antihelix. The nodule usually enlarges rapidly to its maximum size and remains stable. Onset may be precipitated by pressure, trauma, or cold. When asked, the patient usually admits to sleeping on the affected side.
Physical Examination
Nodules are firm, tender, well demarcated, and round to oval with a raised, rolled edge and central ulcer or crust. Removal of the crust often reveals a small channel. Color is similar to that of the surrounding skin, although a thin rim of erythema may be noted. Size may range from 3-20 mm. The right ear is affected more commonly than the left, and occasionally bilateral distribution is reported. [11] Lesions develop on the most prominent projection of the ear. The most common location is the apex of the helix. Distribution on the antihelix is more common in women.
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Classic chondrodermatitis nodularis chronica helicis on the superior helix.
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Close-up view of classic chondrodermatitis nodularis chronica helicis.
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Chondrodermatitis nodularis chronica helicis on the antihelix.
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Taken during surgery, this photo demonstrates reflection of the skin, which reveals the underlying perichondrium and cartilage. After the cartilage is removed, the flap is reapproximated and sutured.
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Taken 6 months after surgery.
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Self-adhering foam in a curvilinear shape is placed on the non–hair-bearing postauricular scalp.
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A rectangular piece of self-adhering foam is placed on the non–hair-bearing postauricular scalp.
