Firm Papules on the Auricular Helix—Quiz Case

Abstract

A 49-year-old white man presented with asymptomatic papules of unknown duration on the bilateral helical rims. These lesions were discovered by his hairdresser 1 week prior to presentation. The patient denied pain, tenderness, or pruritus. His medical history was noncontributory, and he denied a history of gout. In addition, he denied a history of wrestling or other trauma, such as frequent use of headgear. Physical examination revealed four 1-to 2-mm, skin-colored to yellowish, smooth-surfaced, firm, round papules on the free margin of both helices (Figure 1). A shave biopsy was performed on the lesion on the right helix (Figure 2 and Figure 3).

A report of 10 individuals with weathering nodules and review of the literature

“…[ 1 ] Various other conditions may mimic weathering nodules, such as basal cell carcinoma, calcinosis cutis, chondrodermatitis nodularis helicis, elastotic nodules, follicular neoplasm (including trichilemmomas), keratoacanthoma, sarcoidosis, squamous cell carcinoma, and tophi. [ 8 ] Chondrodermatitis nodularis helicis lesions are typically painful, pink or gray, often with a central crust-like scale or ulceration. [ 1 ] Elastotic nodules can be recognized as bilateral, pale, semi-translucent aggregates of pink-white material, with an orange-peel-like surface and associated pain.…”