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Chondrodermatitis Nodularis

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What is chondrodermatitis nodularis?

Chondrodermatitis nodularis is a common, harmless, painful condition of the skin of the ear. This condition is an inflammation of both the cartilage (chondro-) and the skin (-dermatitis), causing a small swelling over-ear pinna.  This condition is more common in middle-aged or elderly males but can happen in women.

What causes chondrodermatitis nodularis?

The exact cause is still not known, but the majority believes that an essential factor is prolonged pressure on the skin of the ear. It may be from sleeping on one side, can happen with prolonged use of headphones, mobile phones, or hearing aids.

Other factors may include damage from cold, the sun, or inadequate blood supply to the ear.

What are the symptoms of chondrodermatitis nodularis?

The symptoms include the sudden appearance of tender or painful nodule over pinna, especially on the right side. The pain can be intense and is usually short-lived, but can disturb sleep. It may sometimes bleed or discharge.

What does chondrodermatitis nodularis look like?

There is usually a single lump, often relatively small (5-10 mm), and typically on the outer side of the upper part of the rim of the ear. It may look red, and its surface can be scaly or crusty. A small raw area or core is often seen in the center when the crust is removed.

How is chondrodermatitis nodularis diagnosed?

The diagnosis is usually clinical, which is done on the patient’s history, site, and appearance of a tender lump on the ear. Sometime skin biopsy may require a diagnosis.

Can chondrodermatitis nodularis be cured?

It usually clears within a few months but can come back.

Self-care (What can I do?)

  • Try to avoid direct and prolonged pressure on the lesion.
  • Try to sleep on the other side; make sure your pillow is soft, and consider modifying it by making a hole where the tender area presses into it.
  • Avoid too much exposure to the cold and the sun. Consider wearing a warm hat that covers the ears.

How can chondrodermatitis nodularis be treated?

Chondrodermatitis nodularis is harmless and not skin cancer.

It can be treated, although the treatments themselves can be painful and are not always successful:

  • A corticosteroid may be applied as a cream or injected into the nodule to reduce pain and redness.
  • Topical nitroglycerin may be used as an ointment but may cause headaches and skin irritation.
  • The lesion can be frozen off with liquid nitrogen.
  • It may be surgically removed by cutting it out, having first numbed the skin with a local anesthetic injection. However, it often comes back after surgery, and so it is essential to avoid pressure on the ear afterward.