Chondrodermatitisnodularischronicahelicis (CNH), also known as Winkler’s Disease after the man that first described it, is an inflammatory condition which affects the cartilage of the ear.
Chondrodermatitis usually happens to men in their 50s and 60s but it can also affect people of any age and gender. It presents itself as sore patch of skin on the cartilage of the ear. The top of the ear is called the helix, hence the ‘helicis’ part of Chondrodermatitisnodularischronicahelicis.
The sore patch will be small, perhaps only a few millimetres wide, but to lie on it causes a lot of pain. Usually a tiny central core can be found. This core discharges a small amount of scaly material. Often confused with skin cancer, the condition can persist for months or even years, ultimately developing into a full-on pressure sore.
What is the cause of Chondrodermatitis?
The cause of Chondrodermatitis is the friction and pressure of one’s head rubbing against the pillow at night. CNH ear occurs in people who are habitual side sleepers. It can also be caused by minor injury or exposure to cold. Reduction in the blood supply of the ear due to the effects of aging prevents adequate healing resulting in a worsening condition without intervention.
How is Chondrodermatitis diagnosed?
Usually a diagnosis is made at the clinic because a painful lesion on the ear is evident alongside the appearance of a small tender spot that may be ulcerated. Sometimes the diagnosis is made via a skin biopsy.
What is the treatment for chondrodermatitis?
You must avoid sleeping on the sore. Check your pillow is soft and consider buying a pillow with a hole in it so there is no pressure on it.This will address the underlying cause of the prpblem.
Wear an insulating hat over the ears when exposed to cold and wind.
If the CNH has turned into a pressure sore, apply an antibiotic cream.
Your GP may suggest treating the pressure sore with a cortisone injection or freeze it.
Topical 2% glyceryl trinitrate may be prescribed in cases which are quite severe. This may have side effects such as headache.
Your doctor may recommend surgical excision.Chondrodermatitis has a 10-30% rate of recurrence after surgery.
There are other options however these are the most common. We have found that the most effective of these treatments is to use a pillow with a hole. This keeps the problem from recurring as the ear no longer presses against the pillow and is not subject to further aggravation.