Fourteen patients are presented with elastotic nodules of the anterior crus of the antihelix. These common lesions are felt to be a distinct entity. They are bilateral, semitranslucent, and appear as aggregates of granular white-to-pink material usually with an overlying "orange peel" surface.
The clinical differential diagnosis includes basal cell carcinoma or an infiltrative lesion such as: rheumatoid nodules, xanthoma, sarcoid, gout, and calcinosis cutis. These may be excluded by hematoxylin and eosin-stained sections and the elastotic nodule identified by elastic stains.
In each of the patients there was significant actinic damage to the remaining exposed skin. This study suggests that the anterior crus is particularly susceptible to actinic damage with local accumulation of elastotic tissue, but without associated malignant lesions.
Carter VH, Constantine VS, Poole WL. Elastotic Nodules of the Antihelix. Arch Dermatol. 1969;100(3):282-285. doi:10.1001/archderm.1969.01610270024005