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NEWPORT BEACH, CALIF. A foam-rubber pad with a hole in it helps many patients avoid surgery for chondrodermatitis nodularis chronica helicis, P. Haines Ely, M.D., said at the annual meeting of the Pacific Derma-tologic Association.
Chondrodermatitis nodularis chronica helicis (CNCH) is a painful pressure sore on the ear that occurs on actinically damaged skin. It is usually seen in middle-aged men, although rare cases have been reported in children who were paralyzed and always slept on the same side.
Traditionally, CNCH is removed by making a small slit in the skin with a scalpel and using curved scissors or a scalpel to snip out the damaged cartilage. The wound is then closed with sutures or with a drop of cyanoacrylate glue.
This approach is associated with a cure rate of about 80%, but there is also a recurrence rate of 10%30%, said Dr. Ely, a dermatologist in private practice in Grass Valley, Calif.
He has had longer-term results with 1-inch-thick foam pads that he buys at a local surplus store in 8-foot sheets for about $10 a sheet. He cuts the sheets into smaller pieces approximately the size of a standard pillow, and then cuts a hole where the patient's ear will go. He instructs the patient to slip the foam between the pillowcase and the pillow, and to sleep with the ear resting in the depression formed by the hole.
If the CNCH does not resolve within 1 month, Dr. Ely has the patient come in for surgical excision. So far, virtually none of his patients have returned for surgery.
"I've actually ruined my surgical practice for chondrodermatitis because this almost always works," Dr. Ely said.
NEWPORT BEACH, CALIF. A foam-rubber pad with a hole in it helps many patients avoid surgery for chondrodermatitis nodularis chronica helicis, P. Haines Ely, M.D., said at the annual meeting of the Pacific Derma-tologic Association.
Chondrodermatitis nodularis chronica helicis (CNCH) is a painful pressure sore on the ear that occurs on actinically damaged skin. It is usually seen in middle-aged men, although rare cases have been reported in children who were paralyzed and always slept on the same side.
Traditionally, CNCH is removed by making a small slit in the skin with a scalpel and using curved scissors or a scalpel to snip out the damaged cartilage. The wound is then closed with sutures or with a drop of cyanoacrylate glue.
This approach is associated with a cure rate of about 80%, but there is also a recurrence rate of 10%30%, said Dr. Ely, a dermatologist in private practice in Grass Valley, Calif.
He has had longer-term results with 1-inch-thick foam pads that he buys at a local surplus store in 8-foot sheets for about $10 a sheet. He cuts the sheets into smaller pieces approximately the size of a standard pillow, and then cuts a hole where the patient's ear will go. He instructs the patient to slip the foam between the pillowcase and the pillow, and to sleep with the ear resting in the depression formed by the hole.
If the CNCH does not resolve within 1 month, Dr. Ely has the patient come in for surgical excision. So far, virtually none of his patients have returned for surgery.
"I've actually ruined my surgical practice for chondrodermatitis because this almost always works," Dr. Ely said.
NEWPORT BEACH, CALIF. A foam-rubber pad with a hole in it helps many patients avoid surgery for chondrodermatitis nodularis chronica helicis, P. Haines Ely, M.D., said at the annual meeting of the Pacific Derma-tologic Association.
Chondrodermatitis nodularis chronica helicis (CNCH) is a painful pressure sore on the ear that occurs on actinically damaged skin. It is usually seen in middle-aged men, although rare cases have been reported in children who were paralyzed and always slept on the same side.
Traditionally, CNCH is removed by making a small slit in the skin with a scalpel and using curved scissors or a scalpel to snip out the damaged cartilage. The wound is then closed with sutures or with a drop of cyanoacrylate glue.
This approach is associated with a cure rate of about 80%, but there is also a recurrence rate of 10%30%, said Dr. Ely, a dermatologist in private practice in Grass Valley, Calif.
He has had longer-term results with 1-inch-thick foam pads that he buys at a local surplus store in 8-foot sheets for about $10 a sheet. He cuts the sheets into smaller pieces approximately the size of a standard pillow, and then cuts a hole where the patient's ear will go. He instructs the patient to slip the foam between the pillowcase and the pillow, and to sleep with the ear resting in the depression formed by the hole.
If the CNCH does not resolve within 1 month, Dr. Ely has the patient come in for surgical excision. So far, virtually none of his patients have returned for surgery.
"I've actually ruined my surgical practice for chondrodermatitis because this almost always works," Dr. Ely said.