External ear tumors - benign / nonneoplastic

Chondrodermatitis nodularis chronica helicis

Topic Completed: 1 October 2013

Minor changes: 14 December 2020

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PubMed Search: Chondrodermatitis nodularis chronica helicis

Nat Pernick, M.D.
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Cite this page: Pernick N. Chondrodermatitis nodularis chronica helicis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/earchondrodermatitis.html. Accessed December 8th, 2021.
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
  • 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
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