Ear
Inflammatory / infectious / autoimmune / systemic disorders
Chondrodermatitis nodularis chronica helicis

Author: Nat Pernick, M.D. (see Authors page)

Revised: 8 February 2018, last major update October 2013

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: Chondrodermatitis nodularis chronica helicis

Cite this page: Pernick, N. Chondrodermatitis nodularis chronica helicis. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/earchondrodermatitis.html. Accessed July 16th, 2018.
Definition / general
  • Also called Winkler's disease
  • Idiopathic, nonneoplastic ulcerative lesion of auricle
  • Usually men ages 40+; uncommon in women
  • Symptoms: appears spontaneously; unilateral, painful nodule
Treatment
  • Wedge or cartilage excision, glucocorticoid injection
  • Frequently recurs
Gross description
  • Dome shaped nodule, 0.3 - 1.8 cm, with crusty scale covering central area of ulceration
Microscopic (histologic) description
  • Central ulceration of epidermis with adjacent acanthosis, hyperkeratosis, parakeratosis and pseudoepitheliomatous hyperplasia
  • Base of ulcer has granulation tissue that usually involves perichondrium and cartilage
  • Usually nerve hyperplasia identified with S100 (J Am Acad Dermatol 2006;55:844)
  • May have foci of fibrinoid necrosis
  • No dermal adnexa at site of lesion
Microscopic (histologic) images

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Infiltration of papillary dermis by epithelioid (E) cells

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External and middle ear

Differential diagnosis
  • Clinically resembles carcinoma
  • Vascular proliferation may resemble a glomus tumor