Chondrodermatitis Nodularis Helicis

Chondrodermatitis nodularis helicis (CNH) is a benign inflammatory nodule on the helix or antihelix of the ear. CNH is also referred to as Winkler’s nodule, Winkler’s disease, chondrodermatitis nodularis chronica helicis, ear pressure sore, and painful nodule of the ear. CNH is characterized by a solitary, firm, well-defined, round to oval nodule or papule. Size of the nodule ranges from 3 to 20 mm. Several etiologies have been proposed, and a widely accepted theory is that chronic pressure leads to ischemia of the underlying cartilage. Diagnosis is typically made clinically, followed by a biopsy when suspicious for malignancy. Differential diagnoses include actinic keratosis, basal cell carcinoma, squamous cell carcinoma, keratoacanthoma, and gouty tophus, among others. A variety of treatment options exist from pressure-relieving methods to topical nitroglycerin to surgery.