A woman in her 50s presented with an edematous, massively enlarged right auricle. The patient had immigrated to Israel 9 years before admission. She was adamant that the lesion had been present since early childhood but had gradually increased with a recent appearance of foul-smelling otorrhea. On examination, the auricle was markedly enlarged, edematous, and encircled by an erythematous, indurated plaque partially covered with a fine scale (Figure 1A). Diascopy revealed an "apple jelly" appearance. There was no local or distant lymphadenopathy; general physical examination findings were unremarkable.Results of routine laboratory investigations, including complete blood cell count, biochemical profile, liver function tests, and chest radiography, were normal. An intradermal Mantoux test induced a 20-mm induration. Histopathologic evaluation of the cutaneous lesion revealed noncaseating granulomatous dermatitis involving the dermis (Figure 1B). High magnification demonstrated tuberculoid dermal granulomas composed of histiocytes and Langhans giant cells surrounded by lymphoplasmacytic infiltrate (Figure 1C). Results of polarized light examination and periodic acid-Schiff, Ziehl-Neelsen, Giemsa, Gram, and Grocott methenamine silver stains were negative for microorganisms.