Chondrodermatitis nodularis helicis as a marker of internal syndromes associated with microvascular injury

Abstract

Chondrodermatitis nodularis helicis (CNH) is held to be an idiopathic degenerative process involving the upper dermis of the auricular rim. Chondrodermatitis typically occurs in elderly men where associations with underlying trauma and sun exposure have been postulated as potential inciting triggers. Its association as a marker of systemic disease is not well established. We describe 24 patients with CNH, in whom there were also significant underlying diseases largely associated with vascular injury including those of immune-based etiology and/or conditions which have been previously linked with granuloma annulare, another necrobiotic process of collagen. These patients with concomitant systemic disease were characteristically younger compared to the classic demographics described for CNH. In some cases, chondrodermatitis may represent an ischemic necrobiotic disorder of collagen, potentially defining an important sign of underlying systemic disease in younger patients.

Neural hyperplasia in chondrodermatitis nodularis chronica helicis

“…18,19 It is not unlikely that CNCH represents, at least in certain cases, an ischemic necrobiotic alteration of collagen that might be associated with systemic diseases characterized by microvascular injury. 20 Our results do not offer a new physiopathologic explanation of CNCH, but we think nerve hyperplasia is of diagnostic value and might explain the characteristic symptoms of this condition. …”

“…We could not find a single case of significantly increased numbers ( [20) of nerves beneath the basal cell or squamous cell carcinomas (0/25 vs 18/37; P \ 10 ÿ4 , Student t test). Even in ulcerated tumors (10 cases), no hypertrophic nerve bundles or smaller nerve bundles were observed close to the surface.…”

“…The number of small nerve sections was small (\10 at low-power field) in 8 cases, intermediate (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) …”

Clinical appearance, differential diagnoses and therapeutical options of chondrodermatitis nodularis chronica helicis Winkler

“…Data in the literature on gender distribution reveal with few exceptions repeatedly a marked male dominance [5,[7][8][9][10]. In some studies their proportion was over 80 % [11][12][13].…”

Infantile Chondrodermatitis Nodularis

“…It typically affects middle‐aged to elderly patients. Very few occurrences of CN in childhood have been described in the Western literature (1–4).…”