Chondrodermatitis nodularis chronica helicis: Difference between revisions

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==Overview==
==Overview==
'''Chondrodermatitis nodularis chronica helicis''' (also known as "Chondrodermatitis nodularis helicis"<ref name="Fitz2">Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.</ref>{{rp|782}}) (CNH) is a small, nodular, tender, chronic inflammatory lesion occurring on the helix of the ear, occurring most often in men.<ref name="Andrews">James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. ISBN 0-7216-2921-0.</ref>{{rp|610}}
'''Chondrodermatitis nodularis chronica helicis''' (also known as "Chondrodermatitis nodularis helicis"<ref name="Fitz2">Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.</ref>{{rp|782}}) (CNH) is a small, nodular, tender, chronic inflammatory lesion occurring on the helix of the ear, occurring most often in men.<ref name="Andrews">James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. ISBN 0-7216-2921-0.</ref>{{rp|610}}
<br />
== Historical Perspective[edit | edit source] ==
* Chondrodermatitis nodularis chronica helicis was first discovered by Max Winkler, a dermatologist, in 1915, in a paper titled Knötchenförmige Erkrankung am Helix . <ref name="pmid21276202">{{cite journal| author=Wagner G, Liefeith J, Sachse MM| title=Clinical appearance, differential diagnoses and therapeutical options of chondrodermatitis nodularis chronica helicis Winkler. | journal=J Dtsch Dermatol Ges | year= 2011 | volume= 9 | issue= 4 | pages= 287-91 | pmid=21276202 | doi=10.1111/j.1610-0387.2011.07601.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21276202  }}</ref><ref name="pmid27399947">{{cite journal| author=Kechichian E, Jabbour S, Haber R, Abdelmassih Y, Tomb R| title=Management of Chondrodermatitis Nodularis Helicis: A Systematic Review and Treatment Algorithm. | journal=Dermatol Surg | year= 2016 | volume= 42 | issue= 10 | pages= 1125-34 | pmid=27399947 | doi=10.1097/DSS.0000000000000817 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27399947  }}</ref>
* in 1925, Foerster further developed the clinical, microscopic and treatment options for CNH.


==Pathophysiology==
==Pathophysiology==


* The pathophysiology remains unclear. It may be due to chronic pressure or trauma or temperature changes or actinic damage to the ear. Prolonged pressure seemed to most commonly reported. Sleeping on the one side can cause this pressure.
*The pathophysiology remains unclear. It may be due to chronic pressure or trauma or anatomic features or temperature changes or actinic damage to the ear. Prolonged pressure seemed the most commonly reported cause. Sleeping on the one side can cause this pressure.
* Other causes can be continuous use of headphones/ ear phones, hearing aids, or can be idiopathic. There are some theories on association with autoimmune disorders and connective tissue diseases like scleroderma, autoimmune thyroiditis, lupus erythematosus, or dermatomyositis.
*Other causes can be continuous use of headphones/ ear phones, hearing aids, or can be idiopathic. There are some theories on association with autoimmune disorders and connective tissue diseases like scleroderma, autoimmune thyroiditis, lupus erythematosus, or dermatomyositis.
* CNH is seen mostly in elderly men. There are cases seen in women and young, especially when associated with autoimmune or connective tissue disorders. <ref name="pmid29926164">{{cite journal| author=García-García B, Munguía-Calzada P, Aubán-Pariente J, Junceda-Antuña S, Zaballos P, Argenziano G | display-authors=etal| title=Dermoscopy of chondrodermatitis nodularis helicis. | journal=Arch Dermatol Res | year= 2018 | volume= 310 | issue= 7 | pages= 551-560 | pmid=29926164 | doi=10.1007/s00403-018-1844-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29926164  }}</ref> <ref name="pmid29805936">{{cite journal| author=Salah H, Urso B, Khachemoune A| title=Review of the Etiopathogenesis and Management Options of Chondrodermatitis Nodularis Chronica Helicis. | journal=Cureus | year= 2018 | volume= 10 | issue= 3 | pages= e2367 | pmid=29805936 | doi=10.7759/cureus.2367 | pmc=5969795 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29805936  }}</ref><ref name="pmid28217474">{{cite journal| author=Kumar P, Barkat R| title=Chondrodermatitis nodularis chronica helicis. | journal=Indian Dermatol Online J | year= 2017 | volume= 8 | issue= 1 | pages= 48-49 | pmid=28217474 | doi=10.4103/2229-5178.198767 | pmc=5297272 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28217474  }}</ref><ref name="pmid27723195">{{cite journal| author=Shah S, Fiala KH| title=Chondrodermatitis nodularis helicis: A review of current therapies. | journal=Dermatol Ther | year= 2017 | volume= 30 | issue= 1 | pages=  | pmid=27723195 | doi=10.1111/dth.12434 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27723195  }}</ref><br />
*CNH is seen mostly in elderly men. There are few cases seen in women and young, especially when associated with autoimmune or connective tissue disorders. <ref name="pmid29926164">{{cite journal| author=García-García B, Munguía-Calzada P, Aubán-Pariente J, Junceda-Antuña S, Zaballos P, Argenziano G | display-authors=etal| title=Dermoscopy of chondrodermatitis nodularis helicis. | journal=Arch Dermatol Res | year= 2018 | volume= 310 | issue= 7 | pages= 551-560 | pmid=29926164 | doi=10.1007/s00403-018-1844-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29926164  }}</ref> <ref name="pmid29805936">{{cite journal| author=Salah H, Urso B, Khachemoune A| title=Review of the Etiopathogenesis and Management Options of Chondrodermatitis Nodularis Chronica Helicis. | journal=Cureus | year= 2018 | volume= 10 | issue= 3 | pages= e2367 | pmid=29805936 | doi=10.7759/cureus.2367 | pmc=5969795 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29805936  }}</ref><ref name="pmid28217474">{{cite journal| author=Kumar P, Barkat R| title=Chondrodermatitis nodularis chronica helicis. | journal=Indian Dermatol Online J | year= 2017 | volume= 8 | issue= 1 | pages= 48-49 | pmid=28217474 | doi=10.4103/2229-5178.198767 | pmc=5297272 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28217474  }}</ref><ref name="pmid27723195">{{cite journal| author=Shah S, Fiala KH| title=Chondrodermatitis nodularis helicis: A review of current therapies. | journal=Dermatol Ther | year= 2017 | volume= 30 | issue= 1 | pages=  | pmid=27723195 | doi=10.1111/dth.12434 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27723195 }}</ref>
*The anatomy of ear pinna can contribute to the pathophysiology of CNH. The pinna has limited blood supply and little subcutaneous tissue, which easily lead to formation of sore with pressure or trauma or cold temperature. <ref name="pmid29210713">{{cite journal| author=Elsensohn A, Getty S, Shiu J, de Feraudy S| title=Intradermal Proliferative Fasciitis Occurring With Chondrodermatitis Nodularis Helicis. | journal=Am J Dermatopathol | year= 2018 | volume= 40 | issue= 2 | pages= 139-141 | pmid=29210713 | doi=10.1097/DAD.0000000000001027 | pmc=6075668 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29210713 }}</ref><br />


==Diagnosis==
==Diagnosis==

Revision as of 16:02, 28 July 2021

File:Chondrodermatitis.jpg
Chondrodermatitis helicis nodularis in a 67-year-old man.


_ Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Karnik Raju Paila Bangaru, M.B.B.S.[2] Kiran Singh, M.D. [3]

Synonyms and keywords:Chondrodermatitis nodularis helicis, winkler disease, ear pressure sore

Overview

Chondrodermatitis nodularis chronica helicis (also known as "Chondrodermatitis nodularis helicis"[1]:782) (CNH) is a small, nodular, tender, chronic inflammatory lesion occurring on the helix of the ear, occurring most often in men.[2]:610


Historical Perspective[edit | edit source]

  • Chondrodermatitis nodularis chronica helicis was first discovered by Max Winkler, a dermatologist, in 1915, in a paper titled Knötchenförmige Erkrankung am Helix . [3][4]
  • in 1925, Foerster further developed the clinical, microscopic and treatment options for CNH.

Pathophysiology

  • The pathophysiology remains unclear. It may be due to chronic pressure or trauma or anatomic features or temperature changes or actinic damage to the ear. Prolonged pressure seemed the most commonly reported cause. Sleeping on the one side can cause this pressure.
  • Other causes can be continuous use of headphones/ ear phones, hearing aids, or can be idiopathic. There are some theories on association with autoimmune disorders and connective tissue diseases like scleroderma, autoimmune thyroiditis, lupus erythematosus, or dermatomyositis.
  • CNH is seen mostly in elderly men. There are few cases seen in women and young, especially when associated with autoimmune or connective tissue disorders. [5] [6][7][8]
  • The anatomy of ear pinna can contribute to the pathophysiology of CNH. The pinna has limited blood supply and little subcutaneous tissue, which easily lead to formation of sore with pressure or trauma or cold temperature. [9]

Diagnosis

Physical Examination

Skin

Ear

References

  1. Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
  2. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  3. Wagner G, Liefeith J, Sachse MM (2011). "Clinical appearance, differential diagnoses and therapeutical options of chondrodermatitis nodularis chronica helicis Winkler". J Dtsch Dermatol Ges. 9 (4): 287–91. doi:10.1111/j.1610-0387.2011.07601.x. PMID 21276202.
  4. Kechichian E, Jabbour S, Haber R, Abdelmassih Y, Tomb R (2016). "Management of Chondrodermatitis Nodularis Helicis: A Systematic Review and Treatment Algorithm". Dermatol Surg. 42 (10): 1125–34. doi:10.1097/DSS.0000000000000817. PMID 27399947.
  5. García-García B, Munguía-Calzada P, Aubán-Pariente J, Junceda-Antuña S, Zaballos P, Argenziano G; et al. (2018). "Dermoscopy of chondrodermatitis nodularis helicis". Arch Dermatol Res. 310 (7): 551–560. doi:10.1007/s00403-018-1844-6. PMID 29926164.
  6. Salah H, Urso B, Khachemoune A (2018). "Review of the Etiopathogenesis and Management Options of Chondrodermatitis Nodularis Chronica Helicis". Cureus. 10 (3): e2367. doi:10.7759/cureus.2367. PMC 5969795. PMID 29805936.
  7. Kumar P, Barkat R (2017). "Chondrodermatitis nodularis chronica helicis". Indian Dermatol Online J. 8 (1): 48–49. doi:10.4103/2229-5178.198767. PMC 5297272. PMID 28217474.
  8. Shah S, Fiala KH (2017). "Chondrodermatitis nodularis helicis: A review of current therapies". Dermatol Ther. 30 (1). doi:10.1111/dth.12434. PMID 27723195.
  9. Elsensohn A, Getty S, Shiu J, de Feraudy S (2018). "Intradermal Proliferative Fasciitis Occurring With Chondrodermatitis Nodularis Helicis". Am J Dermatopathol. 40 (2): 139–141. doi:10.1097/DAD.0000000000001027. PMC 6075668. PMID 29210713.
  10. 10.0 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 "Dermatology Atlas".


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