Chondrodermatitis
Nodularis Helicis.
Tender nodule on the outside of your ear.
Chondrodermatis
Chondrodermatitis of The Ear often looks similar to an SCC.
Chondrodermatitis
What is Chondrodermatitis?
Chondrodermatis Nodular Helicis (CNH) Chondrodermatis Nodular Helicis (CNH) literally means ‘inflamed cartilage on the rim of the ear’. It’s usually a pink, well-defined nodule on the rim of the outer ear. This is not a form of cancer.
You can think of CNH as a type of cartilage damage caused by:
- Chronic sun exposure
- Cold weather exposure
- Pressure caused by your sleeping position or by pressing a phone to your ear all the time
Who gets them?
CNH occurs more frequently in people with fair skin and men are 4-5 times more likely to have these nodules. It is rarely reported in children.
- Men usually develop these nodules on the helix, which is the upper curve of the ear.
- Women tend to have nodules on the antehelix, which is the cartilage ‘bar’ across the centre of the ear.
The cartilage in your ear is very delicate because it’s so close to the surface. There’s very little skin or other tissue protecting it, so it’s easy to damage. The blood flow in this part of the body is also quite weak because the blood vessels are very small. This means that injuries to the ear can take a long time to heal, or not heal at all.
Chondrodermatis is different from the common weathering nodule of the ear which occur commonly in older guys. These small nodules occur on the outer helix and are not sore or tender.
What are the clinical features?
CHN lesions are solitary, firm nodules that are 4-6 millimetres in diameter and found on the outer ear. The lesions are skin-coloured and are typically scaly and painful. A small ulcer may also be present in the nodule’s centre.
A CHN Lesion can look very similar to certain types of skin cancer.
Gallery of Chondrodermatitis
Please click on the images for details.
CMH .v. Skin Cancer
| Age & Sex | Location | Speed of Growth | Shape & Size | Colour | Other Features | |
|---|---|---|---|---|---|---|
| CNH | More common in males from mid-30’s upwards | Most commonly upper part of the ear | Rapid initial growth and then stops | Dome Shaped, can be 4 to 20mm but most commonly around 5-10mm | Skin coloured or pink | May have a small ulcer in the centre |
| Skin Cancer | More common in men and older age | You can find the sores anywhere on the ear that is sun exposed | Can be rapid or slower growing depending on type. | Flat, slightly raised or nodular, and sores continue to grow | Skin coloured, pink, pigmented, or red. Basal Cell Carcinomas may be shiny with visible blood vessels | May have a central ulcer. SCC often has a collar of red tissue around the base |
What is the treatment of Chondrodermatitis?
Firstly, you need to confirm that you have CNH, this can be done by having a skin biopsy with your doctor for an accurate diagnosis. Once it has been determined that you have CNH, there are two basic treatment paths:
Surgical Treatments
There are several options when it comes to surgical treatments for CNH. Firstly, there is curettage, which means your doctor will remove the lesion when you have the initial biopsy. However, your doctor may want to perform a shave biopsy rather than a full removal if there’s a chance that the nodule is cancerous. During a shave biopsy, your doctor will make a shallow cut to remove a high-quality tissue sample. This procedure cuts down on scarring and makes the results of cancer tests more accurate.
If you have the entire nodule removed, the quality of the sample will decline. So, talk to your doctor about the likelihood of skin cancer and the best option to protect your health before you choose the surgical option.
Some other surgical options include:
- Formal excision of the nodule, which means your doctor will remove the tissue down to the cartilage and put sutures in
- Cryotherapy, where the nodule is literally frozen off
These approaches each have their advantages and disadvantages so consider your options carefully before making a decision.
The Takeaway
Don’t be afraid to talk to a skin specialist if you’re concerned about any lesions or spots on your skin. After all, it may prove to be something harmless like CNH. And if it’s not, then early detection is key to the best outcome possible.
Non-Surgical Treatments
The key to non-surgical treatments is to reduce pressure on the lesion. Identify when and how you’re putting pressure on it. If it’s because of your phone, then deliberately change ears and allow the lesion to heal. Once the nodule has healed, try to change your phone from one ear to the other regularly.
Most of the time, you develop a CNH lesion because you sleep on that side. There are a few remedies for that:
- Get a piece of foam or rubber and cut a hole in it. Position the hole over the lesion, so it doesn’t touch your pillow at night.
- Look for a CNH pillow or chrondrodermatitis pillow online
- Be more vigilant about sun protection on the affected side
- Keep your ears warm whenever possible!
If you experience a lot of pain or discomfort, your doctor may also recommend that you apply a steroid cream or have a steroid injection to reduce the discomfort of the nodule.
Chondrodermatitis may be treated by cutting out a hole in some foam and attaching it around the forehead
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