Chondrodermatitis nodularis chronica helicis
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| Chondrodermatitis nodularis chronica helicis | |
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| Diagnosis in short | |
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| Synonyms | chondrodermatitis nodularis helicis, Winkler disease |
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| LM | cartilaginous pathology (esp. perichondrial inflammation, perichondrial disruption +/-necrosis, +/-hemorrhage), overlying dermal inflammation, epithelial hyperlasia, (dermal) fibrosis |
| Gross | papule on ear, +/-erythema, +/-crusting |
| Site | skin - ear only be definition |
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| Clinical history | more often right ear |
| Signs | tenderness |
| Symptoms | pain |
| Prevalence | uncommon |
| Prognosis | benign |
| Clin. DDx | BCC, SCC |
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.[1]
General
- Tender/painful - key clinical feature.
- Typically right ear - people more often sleep on this one.[2]
- Usually >40 years old.
Etiology:
- Trauma/mechanical.
Gross
- Papule on ear.
- +/-Erythematous.
- +/-Crust.
Clinical DDx:[2]
Images
CNCH. (WC)
www:
Microscopic
Features:[2]
- Dermal inflammation.
- Epithelial hyperlasia.
- Fibrosis.
- Cartilaginous pathology:
- Perichondrial inflammation - key feature.
- Perichondrial disruption.
- +/-Necrosis.
- +/-Hemorrhage.
Images
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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.