Management of chondrodermatitis nodularis chronica helicis using a ‘doughnut pillow’

Abstract

Conservative treatment of chondrodermatitis nodularis chronica helicis using a doughnut pillow is very cost effective.

Long‐term recurrence rates following excision and cartilage rim shave of chondrodermatitis nodularis chronica helicis and antihelicis

“…Smaller studies have reported rates of chondrodermatitis nodularis chronica helicis on the ipsilateral sleeping side as high as 77–99% in the studied chondrodermatitis population. Chondrodermatitis has also been described in the antihelix of nuns who wore coifs and telephone operators using headphones .…”

“…Many conservative treatment strategies have been suggested such as the use of a ‘doughnut pillow’. In one such study, nearly half of the patients were still symptomatic at 1 year . Moncrieff and Sasson reported better cure rates of 87% with the pressure‐relieving prosthesis, but had a small cohort of 15 who were followed up on average for only 18 weeks.…”

“…Patients usually present with a solitary firm, painful nodule that is 4–6 mm in diameter, pink or grey in colour and may be surrounded by an area of erythema . The nodule is often oval shaped with a raised edge and central crust or depression . It is tender to touch and often prevents patients from sleeping on the affected side.…”

“…The helix is predisposed to this condition because there is minimal subcutaneous tissue with a poor blood supply. Prolonged, excessive pressure such as that created by sleeping on one side is thought to be a major contributory factor. It is suggested that specific perichondrial arteriolar changes may lead to underlying cartilage necrosis (Fig.…”

Clinical appearance, differential diagnoses and therapeutical options of chondrodermatitis nodularis chronica helicis Winkler

“…Surgical measures (wedge-shaped excisions and cartilage resections, excision biopsy with fullthickness skin grafting) [6,9,18,20,[26][27][28][29] Curettage/ electrocauterization [35,36] C0 2 laser [37,38] Argon laser [19] Pressure-relieving padding [17,[30][31][32][33] Glucocorticoid injections [8,39] Collagen injections [40] Topical glucocorticoids [41] …”