What is Chondrodermatitis Nodularis Chronica Helicis?
Chondrodermatitis Nodularis Chronica Helicis is quite a common inflammatory disorder which affects the external part of the ear, medically termed as pinna. It is the helix and antihelix which are the part of the pinna that gets affected due to Chondrodermatitis Nodularis Chronica Helicis. This condition is seen more in males above the age of 40 or in the elderly population. However, there are cases where females have also been affected with Chondrodermatitis Nodularis Chronica Helicis. In a study conducted way back in 2006, out of 70 patients treated for this condition, 70% were males and the 16% were females [1].
There have been also cases of Chondrodermatitis Nodularis Chronica Helicis seen in infants and children.
What Causes Chondrodermatitis Nodularis Chronica Helicis?
What exactly causes this condition is not entirely clear and is still being researched. However, some researchers are of the belief that it may be caused due to excessive pressure being out on the external ear. The complex structure of the ear also makes it vulnerable to conditions like Chondrodermatitis Nodularis Chronica Helicis [1].
Among the various causes which put pressure on the external ear, it is sleeping on the affected ear which is believed to be the primary reason. Additionally, trauma or injury to the external ear can also result in the development of Chondrodermatitis Nodularis Chronica Helicis. Some people with autoimmune disorders also have Chondrodermatitis Nodularis Chronica Helicis and this is believed to be due to microvascular injury [1].
Chondrodermatitis Nodularis Chronica Helicis can be extremely painful and discomforting, especially in children and thus requires prompt treatment. [1]
What Are The Presenting Features Of Chondrodermatitis Nodularis Chronica Helicis?
The primary presenting feature of a Chondrodermatitis Nodularis Chronica Helicis is a raised painful nodule on the ear cartilage. The size of the nodule grows as the condition advances. The center of the nodule will be filled with fluid which at times will ooze. Once the nodule dries off then the fluid present in it may result in formation of a scab. The nodule will be extremely tender to touch and just a light touch may cause stinging pain in the ear [2].
Exposure to cold temperatures also causes the nodule to become irritated and cause pain. If an individual tries to pick or burst the nodule then it will only complicate the issue. On average, a nodule caused by Chondrodermatitis Nodularis Chronica Helicis can last anywhere from months to years. This nodule in majority of the cases is caused when sleeping on one side. This is because of disruption of blood flow in the affected area [2].
There is no evidence to suggest that nodule due to Chondrodermatitis Nodularis Chronica Helicis is related to skin cancer and this condition is not inherited. It usually appears after a trauma such as being hit on the ear damaging the cartilage. Prolonged use of headphones and telephones also at times increases the chances of developing Chondrodermatitis Nodularis Chronica Helicis [2].
Autoimmune systemic illness is also a primary reason for Chondrodermatitis Nodularis Chronica Helicis.
How is Chondrodermatitis Nodularis Chronica Helicis Treated?
Coming to treatments of Chondrodermatitis Nodularis Chronica Helicis, it can be done by following certain home remedies or in some cases using some medications. The self-treatment strategies used for treating Chondrodermatitis Nodularis Chronica Helicis include not sleeping on the affected side so that pressure is not put on that ear [2].
The affected individual can also use a soft pillow to decrease pressure on the unaffected ear. Wear ear protectors to prevent any injuries to the external ear especially when in extreme heat or cold. It is also helpful to wear a scarf or a hat pulled low and covers the ears to prevent it from getting damaged. It is also beneficial to not press the phone too tightly to the ear. Sometimes, applying Vaseline or other form of petroleum jelly to the affected ear on the nodule is also beneficial for treatment of Chondrodermatitis Nodularis Chronica Helicis [2].
If these measures are not effective, then a consultation with a physician will be required for treatment of the condition. This is especially when the condition significantly impacts the quality of life of the patient. This can be done with medications and surgery. If the nodule gets infected then the patient will be given antibiotics to clear the infection. This will be followed by administration of steroids to reduce the inflammation and erythema [2].
In some cases, a steroid injection may be directly given to the nodule. Sometimes, physicians inject collagen to the ear to increase protection to the sensitive cartilage around the external ear. In some cases, physicians freeze the nodule by liquid nitrogen for expedited healing of the condition. In severe cases where the patient is experiencing significant difficulties and poor quality of life due to Chondrodermatitis Nodularis Chronica Helicis then the physician may resort to administration of nitroglycerin [2].
Some experts believe that using a nitro patch can significantly improve the blood circulation in the ear. This results in the nodule to become smaller with time. However, this medication comes with a side effect profile of headaches, decreased blood pressure and facial flushing. In rare cases, some physicians use laser beams to destroy the nodule and treat the condition [2].
Until about a decade ago, surgery was the frontline treatment for Chondrodermatitis Nodularis Chronica Helicis. However, with more research on this topic led everyone to believe that conservative measures are as effective as surgical treatment for Chondrodermatitis Nodularis Chronica Helicis. However, surgery is still needed in extreme cases of this condition when conservative measures are not effective in providing relief to the patient [2].
The surgery will involve removal of the nodule and sending the tissue for biopsy. This is done under local anesthesia. Despite removal of the nodule surgically, there is still a chance of the condition recurring. Studies estimate around 38% chances of the nodule recurring even after surgical removal. This usually happens when the surgeon is unable to remove the nodule completely when performing surgery [2].
In conclusion, Chondrodermatitis Nodularis Chronica Helicis is quite a painful condition even though the severity of the pain may be variable and differ from individual to individual. Home remedies usually are quite effective in not only providing relief from the symptoms but also decrease the size of the nodule. However, Chondrodermatitis Nodularis Chronica Helicis is in no way cancerous and does not spread from person to person [1, 2].
It is a treatable condition with the overall prognosis being extremely good post treatment. There is a chance of the nodule recurring even after surgical removal but this usually happens in less than 40% of cases. In other cases, medications and other procedures like freezing of the nodule with liquid nitrogen are quite effective in treating Chondrodermatitis Nodularis Chronica Helicis. Surgery is reserved as a last resort for treating this condition [1, 2].
This is done when other conservative measures are deemed ineffective in providing relief. While performing the procedure, a biopsy will be conducted of the nodule as well. In case if the condition is left untreated, the nodule may get infected causing more severe discomfort to the patient. Thus, it is essential for people with Chondrodermatitis Nodularis Chronica Helicis to get evaluated and treated to prevent any unwarranted complications [2].
