Chondrodermatitis Nodularis Helicis
Chondrodermatitis nodularis helicis is an inflammatory process of the cartilage of the ear. It is an exquisitely tender papule on the most lateral edge of the helix or antihelix. The lesion usually occurs after the age of 40 and the incidence increases with age. Men are affected more often than women. The helix is involved more commonly in men. Lesions on the antihelix are more common in women. These variations may relate in part to historical differences in sun exposure patterns, occupation, recreational activities, and hair styles. As a rule, most patients are in the habit of sleeping on the affected side. Pressure from resting on a pillow causes pain, forcing the patient to alter sleeping position and affecting the ability to sleep comfortably. The etiology of chondrodermatitis nodularis helicis is unclear. It is believed to be related to focal dermal necrosis due to repetitive trauma. Over many years, dermal injury may result from actinic damage, physical pressure, or a combination of both. The vascular supply to this tissue is tenuous, and damage is slow to heal. Inflammation and granulation tissue reflect attempts at healing the damaged collagen. Without treatment, the lesions persist indefinitely. Recurrences are common, even after aggressive therapy.