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Chondrodermatitis nodularis helicis in Adult
Other Resources UpToDate PubMed

Chondrodermatitis nodularis helicis in Adult

Contributors: Sruthi Renati MD, Belinda Tan MD, PhD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Chondrodermatitis nodularis helicis (chondrodermatitis nodularis chronica helicis et antihelices, or CNH) is a common, benign inflammatory condition of the helical or antihelical cartilage and overlying skin with an exquisitely tender, small erythematous papule (or papules).

Repeated trauma, pressure, and subsequent decreased blood flow and ischemic necrosis of the affected cartilage and overlying dermis are thought to promote this condition. This chronic pressure may be due to patients preferentially sleeping on the affected side of the head. Another possible cause is chronic pressure from cell phone use on the affected side. Cold, radiation therapy, and actinic damage may be exacerbating factors.

This condition is more common in middle-aged to elderly men with light skin phototypes. In men, CNH favors the helix, whereas in women, the antihelix is more commonly affected. The condition can rarely occur in children. There have been no reports of malignant degeneration.

Codes

ICD10CM:
H61.199 – Noninfective disorders of pinna, unspecified ear

SNOMEDCT:
76583009 – Chondrodermatitis nodularis helicis

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Last Reviewed:08/12/2018
Last Updated:12/04/2019
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Patient Information for Chondrodermatitis nodularis helicis in Adult
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Contributors: Medical staff writer

Overview

Chondrodermatitis nodularis helicis is a common inflammatory condition of the ear's cartilage and overlying skin. The condition presents with very tender, small bumps (papules) or rounded lumps (nodules).

Patients have a history of preferentially sleeping on the side of affected ear and cannot avoid doing so. Repeated trauma to the cartilage is felt to promote this condition.

Who’s At Risk

Chondrodermatitis nodularis helicis can occur in most age groups and both sexes, but the typical patient is a middle-aged to elderly male with a significant history of sun exposure.

Signs & Symptoms

Chondrodermatitis nodularis helicis is located on the upper concave surfaces of the ear. Small skin-colored, extremely tender lumps are seen there, sometimes slightly scaly or crusty at the center of the lesion.

Self-Care Guidelines

Chondrodermatitis nodularis helicis can be prevented by avoiding pressure and repeated trauma to the affected ear. Positioning the head to the other side while sleeping as well as using the other ear when talking on the phone or using headsets can often lessen aggravation of the affected area.

When to Seek Medical Care

If a painful nodule on the ear is noted, seek evaluation by a primary care provider or dermatologist. A skin biopsy may be needed to rule out a certain type of skin cancer (squamous cell carcinoma).

Treatments

Your physician may recommend self-care measures, such as protecting the ear from trauma by taping a cotton ball just below the lump or surrounding the ear in a foam protector. Your physician may also suggest sleeping with the other ear to the pillow, or avoiding other means of pressure to the affected ear.

Other therapies may include:
  • Injections of 5 mg/cc triamcinolone into the lump (to decrease inflammation)
  • Clobetasol propionate cream
  • Surgical excision (if the lesion is small)

References


Bolognia, Jean L., ed. Dermatology, pp.1400-1401. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp.778, 782-783. New York: McGraw-Hill, 2003.
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Chondrodermatitis nodularis helicis in Adult
A medical illustration showing key findings of Chondrodermatitis nodularis helicis : Anti-helical rim of ear, Ear, Helical rim of ear, Painful skin lesion, Firm papules
Clinical image of Chondrodermatitis nodularis helicis - imageId=24495. Click to open in gallery.  caption: 'A small crusted papule with a collarette of scale on the helix.'
A small crusted papule with a collarette of scale on the helix.
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