Chondrodermatitis Nodularis Helicis Workup

Updated: Aug 13, 2019
  • Author: Victor J Marks, MD; Chief Editor: Dirk M Elston, MD  more...
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Workup

Laboratory Studies

Magro et al. recommend that chondrodermatitis patients in the fourth decade of life should be investigated for underlying systemic disease. This recommendation originates from a study conducted by Magro et al that included 24 patients with chondrodermatitis at a mean age of 43 years who also had increased association with collagen-vascular disease, scleroderma, hypertension, thyroid disease, and heart disease. [7]

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Other Tests

Performing skin biopsy and visualizing characteristic pathologic changes with light microscopy are the standard method of diagnosis.

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Procedures

Biopsy is indicated if the diagnosis of chondrodermatitis nodularis chronica helicis (CNH) is in doubt. Often, biopsy is necessary to differentiate chondrodermatitis nodularis chronica helicis from basal cell carcinoma or squamous cell carcinoma because many patients with chondrodermatitis nodularis chronica helicis have chronic actinic damage and a history of skin cancer.

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Histologic Findings

The histologic changes are similar to those seen in decubitus ulcers, but on a smaller scale. Within the central portion of a shave biopsy, the epidermis usually is ulcerated. At the periphery, intact epidermis is edematous and acanthotic. The dermis below the ulceration demonstrates homogeneous acellular collagen degeneration with fibrin deposition. Granulation tissue flanks the zone of necrosis on both sides. A focus of cartilaginous degeneration may be present, although it is usually minimal. Changes of proliferative fasciitis may rarely be noted. [10]

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