Chondrodermatitis nodularis chronica helicis is a painful nodule of the external ear. These uncommon lesions are most often encountered on the helix in white men older than 40 years, although they also rarely occur on the antihelix in women. The lesions frequently present with exquisite tenderness that interferes with sleep. While the cause of this dermal inflammatory process is not known, long-term trauma or sun damage may play a role. Recurrences often complicate treatment if all sites of inflammation are not eradicated. Surgical treatment is generally recommended, either by wide excision or by deep shave and treatment of the underlying cartilage.
Rosacea is a common skin disorder most often seen in individuals between the ages of 30 and 60. The condition frequently produces erythema, papules, pustules, and edema of midfacial skin. Ocular rosacea occurs in a high percentage of patients, and is a major cause of red eye. A variety of treatments exist that can eliminate pustules, but no therapy is highly effective in eliminating the vascular flushing associated with rosacea.
Superficial fungal infections of the skin are a common presentation in clinical practice. Any skin surface, the mucous membranes, nail plates, and nail beds can be affected. Tinea pedis is the most common fungal infection and may affect up to 70% of the adult population worldwide. Ubiquitous candidal organisms are found in the oral flora of many healthy persons and result in infection in the presence of certain host factors or immunodeficiency disorders. Onychomycosis has had an increasing incidence worldwide, and it now accounts for almost half of all nail disorders. These and many other infections can have varying presentations as well as features that resemble nonfungal disorders. Therefore, it is important that primary care physicians are familiar with the many cutaneous fungal infections and their differential diagnosis to ensure that appropriate therapy is selected.
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