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A previously healthy man in his 20s presented with a 5-month history of tender left pinna swelling associated with tinnitus, hearing loss, and headaches. He denied trauma or preceding or concurrent illnesses, including fever or chills. His social history was only remarkable for an international trip prior to onset. Physical examination revealed multiple erythematous nodules effacing the left external ear and obscuring the external auditory canal (Figure, A). He had no other cutaneous findings, nor did he have lymphadenopathy or hepatosplenomegaly.
Lin SK, Guralnick MP, Cassarino DS. Elusive Diagnosis of Left Ear Nodules. JAMA Dermatol. 2014;150(1):81-82. doi:10.1001/jamadermatol.2013.5371