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Off-Center Fold
April 1998

An Unusual Papule

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Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998

Arch Dermatol. 1998;134(4):499-504. doi:

The papule was removed with a small elliptical excision, including the underlying cartilage, and the excision was closed primarily with excellent cosmetic results.

The accessory tragus is a developmental anomaly of the first brachial arch that rarely causes difficulty for the patient but at times comes to the attention of the dermatologist for investigation, diagnosis, and treatment if it is of sufficient size to cause cosmetic concern. Minor problems may emerge if it is incorrectly identified or surgically mismanaged. In addition, if it is located in its more common presentation, anterior to the tragus or just anterior to the helix, it may be a subtle sign of a more serious underlying congenital abnormality.1 The dermatologist must be able to distinguish, clinically and histologically, the accessory tragus from other abnormalities that occur in the same region.

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