Chondrodermatitis nodularis chronica helicis

Chondrodermatitis nodularis chronica helicis, abbreviated CNCH, is an uncommon painful condition that afflicts the ear.

It is also known as chondrodermatitis nodularis helicis and Winkler disease.

General

• Tender/painful - key clinical feature.
• Typically right ear - people more often sleep on this one.
• Usually >40 years old.

Etiology:

• Trauma/mechanical.

Gross

• Papule on ear.
• +/-Erythematous.
• +/-Crust.

Clinical DDx:

• BCC.
• SCC.

Images

• 

  CNCH (WC)

www:

• CNCH (dermnetnz.org).

Microscopic

Features:

• Dermal inflammation.
• Epithelial hyperlasia.
• Fibrosis.
• Cartilaginous pathology:
  • Perichondrial inflammation - key feature.
  • Perichondrial disruption.
  • +/-Necrosis.
  • +/-Hemorrhage.

Images

• CNCH (dermpedia.org).
• CNCH (surgicalpathologyatlas.com).
• CNCH (dermatlas.med.jhmi.edu).

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Superficial biopsy

SKIN LESION, LEFT ANTIHELIX OF EAR, BIOPSY:
- SUPERFICIAL SKIN WITH ACANTHOSIS, HYPERKERATOSIS, MODERATE SOLAR ELASTOSIS, 
  HYPERGRANULOSIS AND A MILD LYMPHOCYTIC PERIVASCULAR INFILTRATE.
- NO CARTILAGE IS IDENTIFIED.
- NEGATIVE FOR DYSPLASIA AND MALIGNANCY.

COMMENT:
The findings are non-specific. Chondrodermatitis cannot be excluded.

See also

• Non-malignant skin disease.
• Dermatopathology