Chondrodermatitis Nodularis Helicis

Question 1

What is it?

Answer 1

Common inflammatory condition affecting cartilage and skin of helix or antihelix
Can be referred to as Winklers disease

Question 2

What are the causes?

Answer 2

Exact cause unknown

Contributing factors include
- chronic pressure e.g. sleeping on one side, trauma
- poor blood supply to cartilage leading to ischaemia, inflammation and nodule formation

Question 3

What are the clinical features?

Answer 3

Painful, firm nodule on Helix(men) or antihelix (women) often measuring 4-6mm
Worse on pressure
Oval shaped with central crust and surrounding erythema
- can bleed or discharge

More common in fair skinned, middle aged and older man
Can mimic SCC

Question 4

What is the management?

Answer 4

Conservative
- relieve pressures
- use protective padding at night

Pharmacological
- topical potent steroids
- intralesional steroid injections e.g. triamcinolone
- topical nitroglycerin: improves blood flow

Surgical
- excision, curettage
- higher recurrence rate