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JAMA Dermatology Clinicopathological Challenge
July 2015

Painful Erythema and Edema of the Ears

Author Affiliations
  • 1Upstate Medical University, Syracuse, New York
  • 2Department of Dermatology, Buffalo School of Medicine and Biomedical Sciences, State University of New York, Buffalo
JAMA Dermatol. 2015;151(7):785-786. doi:10.1001/jamadermatol.2014.5535

A man in his 70s presented with erythematous ears associated with a burning sensation. He reported that the lesions had begun 6 months previously and that they were most bothersome at the end of the day or when he was exposed to the cold and damp environment while out on his boat. He applied ice to alleviate the burning, but this worsened the condition. A heating pad provided some measure of relief, as did a brief course of systemic corticosteroids.

Physical examination revealed that some papular lesions were associated with slight purpura and hemorrhagic crust (Figure, A). Histologic findings from biopsy specimens were also obtained by routine histologic analysis (Figure, B) and direct immunofluorescence examination (Figure, C).

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