Prevalence of weathering nodules of the ear in patients treated at the state civil servant's hospital of São Paulo, Brazil*

Abstract

BACKGROUNDWeathering nodules of the ear are pale yellow, asymptomatic lesions which predominate on the helices of the ears. Although their pathogenesis remains unknown, there is an association with chronic exposure to ultraviolet radiation, age and thermal injuries. Few studies have been conducted to date, and these involved a very small number of patients. OBJECTIVEStudy the prevalence of weathering nodules of the ear in patients treated in the Dermatology Service of the State Civil Servant's Hospital of São Paulo, and evaluate their probable relationship with sun exposure, age and phototypes I and II. METHODSFour hundred patients older than 20 years of age were examined between July 2008 and December 2008. A questionnaire evaluating age, sex, place of birth, origin, occupation and history of sun exposure was applied. All patients were examined and evaluated for the presence of lesions by only one person. RESULTSThe data showed that 155 (38.8%) patients had a lesion in at least one of the ears. The Chi-Square Test was used for the comparative analysis between the groups of patients with and without lesions. In the group of patients with lesions, 29% were 70 to 79 years old, 78.1% had a history of sun exposure and 45.1% belonged to FITZPATRICK skin phototypes I and II (p<0.05%). CONCLUSIONThe findings suggest relevant prevalence, probable association with chronic sun exposure, advanced age and phototypes I and II.

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

“…Weathering nodules were also found to be more common within the tropical population studied (38.8%, 155/400) when compared to a nontropical population (4%, 4/100). [ 1 5 ] These data support the hypothesis that sun exposure has a significant role in the pathogenesis of these lesions. In addition, weathering nodules were previously thought to be found exclusively in white- or light-skinned populations; indeed, they had previously been described as “a condition found on Caucasian men who have a history of significant cumulative sun exposure.”[ 7 ] Although this claim was substantiated by earlier individual case reports, an epidemiologic study recently described five patients (17%, 5/29) with Fitzpatrick skin phototype V who had weathering nodules.…”

“…However, a more recent epidemiologic study of 400 patients performed on a tropical population (Brazil) found an increased incidence of weathering nodules in women. [ 5 ] They observed weathering nodules in 81 of 230 women as compared to 74 of 170 men. [ 5 ] It has been proposed that women's ears are normally protected from the sun by their long hair, protecting them from sun-induced ear damage.…”

“…[ 5 ] They observed weathering nodules in 81 of 230 women as compared to 74 of 170 men. [ 5 ] It has been proposed that women's ears are normally protected from the sun by their long hair, protecting them from sun-induced ear damage. [ 4 6 ]…”

“…In addition, weathering nodules were previously thought to be found exclusively in white- or light-skinned populations; indeed, they had previously been described as “a condition found on Caucasian men who have a history of significant cumulative sun exposure.”[ 7 ] Although this claim was substantiated by earlier individual case reports, an epidemiologic study recently described five patients (17%, 5/29) with Fitzpatrick skin phototype V who had weathering nodules. [ 5 ] However, to the best of our knowledge, no Fitzpatrick phototype VI patients with weathering nodules have been reported.…”