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Medical Education Section
Do you know what the large blister on the ear of this woman is?
27 year old woman presents with a large blister of 5 months duration on the helix of her ear of 5 months duration. She reports mild tenderness with pressure. She is otherwise healthy.

What is your diagnosis? 

Pseudocyst of the Auricle
Diagnosis:
Pseudocyst of the Auricle (Pseudocyst of the Ear)

Synonyms:
-Endochondral pseudocyst
-Cystic chondromalacia
-Intracartilaginous cyst

Pseudocyst of the auricle usually arises in the scaphoid fossa of the ear of a middle-aged man. Lesions are usually unilateral. They present as a painless swelling, and they tend to arise over the course of a few weeks. The etiology of pseudocyst of the auricle is unknown, but the presence of a potential space during embryogenesis and chronic trauma have been suggested.

Pathology

Biopsy specimens show a cavity within the auricular cartilage (without an epithelial lining) that contains clear fluid. Fibrous tissue and granulation tissue may be found in the cavity as well. The cartilage lining the cavity may show degenerative changes. No inflammation is seen within the cartilage, a distinguishing feature from relapsing polychondritis, which is frequently in the clinical differential diagnosis.

Treatment

Treatment options include aspiration, with or without intralesional injection of corticosteroids, as well as incision and drainage with destruction of the cavity. Each of these modalities should be followed by pressure dressings.

Charles E. Crutchfield III, MD
Clinical Adjunct Associate Professor of Dermatology
At the
University of Minnesota Medical School
Medical Director, Crutchfield Dermatology
www.CrutchfieldDermatology.com


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