A 71-year-old woman sought medical attention for a chronically painful ear lesion.
Key point: Examination revealed a 0.5 cm ulcerated and tender nodule on the superior pole of the antihelix of the left ear. This strongly suggests basal cell or squamous cell carcinoma. A biopsy, however, disclosed only an intense inflammatory infiltrate extending to and into the cartilage. This is characteristic for chondrodermatitis nodularis helices (CNH)—an idiopathic inflammatory disorder of the external ear.
Treatment: Surgical debridement, coupled with injection of dilute triamcinolone(Drug information on triamcinolone) acetonide suspension (2-3 mg/mL) may be employed. In this case, intralesional steroid injections to the ulcer base and lesion periphery were performed after the biopsy. The area healed and did not recur.
Note: CNH is usually painful, whereas skin cancer of the pinna is rarely painful.