Mj. Hudson-peacock et al., The long-term results of cartilage removal alone for the treatment of chondrodermatitis nodularis, BR J DERM, 141(4), 1999, pp. 703-705
Cartilage excision alone has been demonstrated to be an effective technique
in the treatment of chondrodermatitis nodularis (CDN), and in the short te
rm is associated with an 80% cure rate. The objective of this study was to
demonstrate that long-term disease control could be achieved using this sur
gical technique. Set in three hospital dermatology departments, 94 patients
with CDN affecting the helix and antihelix were contacted by postal questi
onnaire at least 6 months after surgery. Replies were received from 77; 11
patients had died and six could not be traced. The main outcome measure was
the identification of those patients in remission and those with disease r
ecurrence. Sixty-two helix lesions were followed up for a mean of 52 months
(range 8-99). There was recurrence in 10 patients (all men; 16%). Twenty a
ntihelix lesions were followed up for a mean of 55 months (range 8-93). The
re was recurrence in five patients (all women; 25%). In conclusion, this st
udy confirms that only cartilage needs to be excised for the long-term effe
ctive treatment of CDN. The only relevant aetiological factor identified wa
s that all except one patient slept on the same side as the CDN. We believe
that pressure on the ear during sleep causes CDN. This is most evident on
the most protuberant part of the ear.