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Clinical Problem Solving
October 2013

Relapsing Papules on the Antihelix of the Left Ear

Author Affiliations
  • 1HagaZiekenhuis, The Hague, the Netherlands
  • 2now with Erasmus University Medical Center, Rotterdam, the Netherlands
JAMA Otolaryngol Head Neck Surg. 2013;139(10):1071-1072. doi:10.1001/jamaoto.2013.4441

A man in his 20s presented with a 10-year history of relapsing papules on the antihelix of the left ear. Less frequently, the papules were found on the right ear as well. Sometimes the lesions were painful to applied pressure or when exposed to cold winds.

On physical examination, the right external ear showed no abnormalities, and the left antihelix showed 5 yellowish papules with surrounding erythema and scattered telangiectasias, firm in consistency and tender to applied pressure. Each lesion measured 3 to 5 mm in size (Figure, A). There was no history of trauma, infection, insect bites, tuberculosis, or diabetes mellitus. The patient used methylphenidate hydrochloride to treat attention-deficit/hyperactivity disorder.