Auricular granuloma annulare

In Reply: Chondrodermatitis nodularis helicis

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In Reply: We thank Dr. Zhang and colleagues for their interest in our article and for their excellent queries. Although granuloma annulare can involve the external ear, it typically occurs on the antihelix, as noted in the excellent article published by Zhang et al 1 The favorable response of relieving pressure to the external ear by sleeping on the unaffected side was more consistent with CNH. The patient described in our article had no evidence for any of the systemic infl ammatory conditions mentioned by Dr. Zhang and colleagues.

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Chondrodermatitis nodularis helicis

“…AGA commonly presents as multiple, asymptomatic, unbroken nodules on unilateral or bilateral ears, although occasionally a solitary crusted nodule with mild tenderness may be present. 2 The main difference is that the pathological features of AGA show dermal collagen degeneration, mucin deposition, and either a palisaded or interstitial histiocytic infi ltrate. Typical pathological fi ndings include a nodule of degenerated homogeneous collagen surrounded by vascular granulation tissue with an overlying acanthotic epidermis, a central ulcer, infl ammation and fi brosis of the underlying perichondrium, and degenerative cartilage.…”