3. All layers of the
overlying skin of the
ear are relatively
thin. Therefore,
many disease of the
auricle of either
tumoral or
inflammatory origin
could easily invade
the underlying
cartilage tissue and
cause permanent
deformities
4.
5. Auricular blood supply
The anterior blood supply comes from the superficial temporal artery. The posterior auricle is fed by the posterior auricular artery.
There is a supplemental blood supply from branches of the occipital artery. The superficiall temporal artery and posterior auricular
artery communicate via the helical arcade; this arcade is the basis for single pedicle reimplantation of a total avulsion of the auricle.
9. Occur in infants of diabetic mothers, and infants with prenatal exposure
to isotretinoin, thalidomide, alcohol, or mycophenolate
10. • First branchial arch
•Preauricular area/ mandibular cheek/ neck/ or ant. border of SCM muscle
•Can be multiple
•Bilateral 10% of cases
•Assoc. cleft lip and palate
12. •Unique congenital prominence that may be found on
the post. helix of the ear.
•Cartilage with overlying layer of skin
•Personal identification in forensic science
•Bilateral / unilateral
•Assoc. : cogenital absence of the helix, accessory
tragus and weathering nodules
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43. • Autoimmune, against type II collagen ( against type IX and XI collagen
have also been described)
•Erythema, swelling and pain of cartilaginous portion of the ear, followed
by destruction of the cartilage
•Nasal chondritis, arthritis of central chest joint
•Complication: Ocular, renal, and respiratory involvement
44. • Daignosis:
•Histologically confirmed chondritis in 2 of the following 3 sites:
auricle, nasal and laryngotracheal cartilage
•Chondritis in one of the aforementioned sites + at least 2 other
features, including: ocular inflammation, audiovestibular damage and
inflammatory arthritis.
•Assoc: other autoimmune (30%) and with myelodysplastic synx
45.
46. •Treatable
•Most common cause of death pneumonia, sysetmic vasculitis,
airway collapse and renal failure.
•Prednisolone ( 0.5 – 1 mg/kg/day)
•NSAIDs and cholchicine
•Dapson ( 50-150 mg/day)
•Hydroxychloroquine and immunosuppressive agents
•Infliximab and IL-1 receptor antagonist
•Retuximab failed to demonstrate significant cllinical improvement
•Surgery
47. An overlap syndrome of RPC and Behçet’s syndrome has been described
in which patients present with features resembling both conditions.
"MAGIC" syndrome, an acronym for mouth and genital ulcers with
inflamed cartilage
48.
49. Chondrodermatitis nodularis helicis (CNH)
• Solitary, firm, painful nodule <10 mm in size, located on the helix or, less
frequently, on the antihelix of the ear
• Cartilage inflammation.
•Chronic trauma, chronic sun exposure, low temperature, and prolonged or
excessive pressure with compromise of local blood supply.
• Asocc.: connective tissue and cardiovascular disease
•CNH occurs most often in middle-aged or older men
•Usually unilateral and typically develops on the same side the patient lies on
in bed
50. •Diagnosis is based upon the clinical appearance and history of rapid
development of a nodular lesion with associated pain and tenderness.
•Histology shows a nodule of degenerated collagen surrounded by a
lymphohistiocytic infiltrate; a central ulceration through which the degenerated
collagen is extruded is often present.
•The DDX: hypertrophic AK, BCC, KA ,SCC, and tophus.
51.
52. •Conservative treatment :relieve pressure and IL. corticosteroids.
•Other treatments that have been evaluated in small numbers of patients
include 2% topical nitroglycerin and photodynamic therapy.
•Surgical : cryotherapy, curettage, CO2 laser ablation, wedge excision, and
cartilage removal alone .
•Recurrence after surgical excision has been reported in 10-30% of patients
53.
54. • Asymptomatic whitish papules ( 2-3 mm) along with the helices
of middle aged or elderly Caucasian men
•Bilateral and multiple
•H/O significant cumulative sun exposure
•Histology: fibrous tissue spur with cartilage metaplasia
•No treatment needed
•cryotharapy
55.
56.
57.
58.
59.
60.
61.
62.
63.
64.
65.
66.
67.
68.
69.
70.
71.
72.
73. • Benign
•Reactive form of lymphoid hyperplasia that can be attributed to
various stimuli, including Borrelia infection
•Early disseminated stage of lyme disease
•B. afzelii and B. garinii
•Most commonly in earlobes in children and nipple/areola in
adult
•+/- lymphadenophathy
•Grenz zone + lymphocytes infiltrate in dermis
•Responds to antibiotics used for Lyme disease + topical and IL
steroid.
74.
75.
76.
77. pseudocyst of the auricle:
•scaphoid, triangular fossa, and antihelix
•endochondral pseudocyst, intracartilaginous cyst, cystic chondromalacia,
and benign idiopathic cystic chondromalacia
•The etiology of this condition is unknown but at the same time many
investigators believe that repeated minor injuries were responsible for the
formation of pseudocysts
•Surgical treatment
78.
79.
80.
81.
82.
83.
84.
85.
86. A cutaneous horn is a keratotic projection the height of
which is at least one-half of the largest diameter . The
mound of compact keratin often resembles a spicule or
cone. Several other skin lesions can present with cutaneous
horns
87. •Usually epidermal type keratin (with granular layer)
•Occasionally has trichilemmal-like features (no granular layer but
deep red granules) - termed trichilemmal horn
•Examination of the base of the lesion is needed to determine the
underlying etiology
•Sometimes base contains epidermal hyperplasia without atypia
