The skin disorders of the ears have a close relationship to the skin disorders of the scalp. In both sexes, the external ears (pinnae), earlobes, conchae, auditory canals, and retroauricular areas are frequent places for the appearance of inflammatory disorders such as seborrheic dermatitis, atopic dermatitis, and psoriasis to occur. The diagnosis of these inflammatory conditions is usually uncomplicated and made on clinical grounds, often aided by evidence of these dermatoses elsewhere on the body.

The earlobes are subject to contact dermatitis, hypertrophic scars, and keloids from earlobe piercings and contact dermatitis from earrings. Chronic cutaneous lupus erythematosus (DLE) also occurs on the external ears, generally on the conchae. An inflammatory process that is often mistaken for an actinic keratosis is chondrodermatitis nodularis helicis, a tender, inflammatory condition of the skin and underlying cartilage of the ear.

Ears that are not protected from the sun are also common sites for the development of actinic keratoses, basal cell carcinomas, and squamous cell carcinomas. Such lesions are noted predominantly in fair-complexioned, elderly men whose hairstyles have not shielded their ears from chronic sun exposure. In contrast, women historically tend to have far fewer of these neoplasms by virtue of longer hairstyles.


Chondrodermatitis Nodularis Helicis

Distinguishing Features

  • Spontaneously appearing tender or painful firm papule with or without a central crust or umbilication

  • Lesions are generally located on the lateral edge of the helix (where there is less direct sun exposure than on the superior surface) (Fig. 5-1); less commonly, CNH occurs on the antihelix (Fig. 5-2)

  • Lesions are 2 to 4 mm in diameter and extremely tender

  • Typically wakes patient from sleep when turning in bed

Actinic Keratosis and Cutaneous Horn

Distinguishing Features

  • Typically, AKs have an erythematous base covered by a white, yellowish, or brown hyperkeratotic scale (Fig. 5-3)

  • Generally, they are asymptomatic

  • AKs may gradually enlarge, thicken, become elevated, and develop into a hypertrophic AK, a cutaneous horn, or a squamous cell carcinoma

Cutaneous Horn

Distinguishing Features

  • Elderly male predominance

  • Scaly, hyperkeratotic papule that obviously sticks out

  • Most often located on superior edge of the helix where there is direct sun exposure (Fig. 5-4)


Distinguishing Features

Jan 8, 2023 | Posted by in Dermatology | Comments Off on Ears

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