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May 2001

Noninflammatory, Fluctuant Swelling of the Ear

Author Affiliations


Arch Dermatol. 2001;137(5):657-662. doi:

The biopsy specimen revealed eosinophilic degeneration of the cartilage associated with perichondrial fibrosis. Granulation tissue characterized by a proliferation of numerous small mature vascular channels embedded in a fibrotic stroma was observed deep to the cartilage. The epidermis and dermis were normal.

Pseudocyst of the auricle is an asymptomatic, noninflammatory cystic swelling that typically involves the scaphoid and triangular fossae of the antihelix in middle-aged men. Only 8 women with this disorder have been described in the literature.1-4 This condition is also referred to as intracartilaginous cyst, endochondral pseudocyst, or cystic chondromalacia of the auricle. The etiology is unknown, and most cases do not have a history of major trauma, although minor trauma may play a role. Clinically, unilateral pseudocyst is the typical presentation, although simultaneous appearance of bilateral pseudocysts of the auricle has been reported.1,2,4-7 Drainage of the cyst typically yields a sterile, viscous, glycosaminoglycan-rich fluid. The viscous fluid varies from clear to serosanguineous and is similar to olive oil. Bacterial and fungal cultures of the fluid are negative. The differential diagnosis of a pseudocyst of the auricle includes relapsing polychondritis, chondrodermatitis nodularis chronica helicis, cauliflower ear, chondroma, hemangioma, angiosarcoma, chondrosarcoma, epidermal inclusion cyst, and subperichondral hematoma.

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