title: [Chondrodermatitis nodularis chronica helicis: a descriptive study of 99 patients].
abstract: BACKGROUND
  Painful nodule of the ear was described at the start of the 20th century as a form of chronic chondrodermatitis nodularis helicis (CNH). It comprises a painful erythematous papule or nodule appearing on the ear and adhering to cartilage, and which may or may not have a central scab. The aim of this study was to describe the clinical characteristics of CNH as well as the population currently affected by such lesions, and to identify predisposing factors. The secondary aim was to describe treatments commonly used in private dermatological practice and to examine their efficacy.
  
  
  METHODS
  Questionnaires were sent out to private dermatologists belonging to the Association d'information post-universitaire en dermato-vénérologie de Strasbourg [Association for post-university information in dermatology-venerology] in Strasbourg. Patients were included in the study if they consulted for CNH, clinically diagnosed as such by the dermatologist. The questionnaire was used to analyze the age, gender and phototype of patients, as well as pain assessed on a numeric scale, duration, site, supposed trigger factors, treatment and outcome after treatment.
  
  
  RESULTS
  A total of 99 patients was included by 27 dermatologists between March 2010 and October 2011, mainly men (sex-ratio: 1.6). The mean age was 65 years. Patients had no significant previous history. Pain was moderate in 23 patients, severe in 59 and unbearable in 14; in most patients it was brought on by provocation (78 patients). The right ear was affected in 48 patients and the left ear in 39. CNH had been present for a mean 14 months. The most common site was the upper/horizontal section and the angle of the helix of the ear (62 patients). Exposure to sunlight or to cold were the predisposing factors most frequently mentioned (56 patients). Medical treatment was given for 52 patients, and resulted in cure of almost half of this population. Surgery was performed in 34 patients, with only one case of relapse.
  
  
  CONCLUSIONS
  Our study shows that the current population of subjects with CNH is comparable with that described in the literature. New professional and technological apparatus appearing in recent decades (hearing aids, headphones and in-ear headphones, crash helmets) result in continual trauma to the ear and could favour the onset of CNH. The treatment most commonly given by dermatologists is non surgical, which may be effective in certain patients. Analgesic treatment and removal of factors responsible for trauma are also important in management.
authors.affiliation: Clinique dermatologique de Strasbourg, hôpital civil de Strasbourg, 1, place de l'Hôpital, 97091 Strasbourg cedex, France. Electronic address: caroline.wettle@hotmail.fr.
authors.forename: C
authors.initials: C
authors.lastname: Wettlé
authors.forename: F
authors.initials: F
authors.lastname: Keller
authors.forename: F
authors.initials: F
authors.lastname: Will
authors.forename: F
authors.initials: F
authors.lastname: Lefebvre
authors.forename: B
authors.initials: B
authors.lastname: Cribier
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D002357:Cartilage Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D002908:Chronic Disease; D003080:Cold Temperature / Q000009:adverse effects; D003131:Combined Modality Therapy; D017679:Cryotherapy; D003872:Dermatitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D004431:Ear, External / Q000293:injuries / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology / Q000628:therapy; D010147:Pain Measurement; D011446:Prospective Studies; D012307:Risk Factors; D013472:Sunlight / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D000700:Analgesics
keywords: Cartilage; Chondrodermatite nodulaire chronique; Chondrodermatitis nodularis helicis; Ear diseases; Helix; Nodule douloureux de l’oreille; Oreille; Painful nodule of the ear