The long-term results of cartilage removal alone for the treatment of chondrodermatitis nodularis.

Cartilage excision alone has been demonstrated to be an effective technique in the treatment of chondrodermatitis nodularis (CDN), and in the short term is associated with an 80% cure rate. The objective of this study was to demonstrate that long-term disease control could be achieved using this surgical technique. Set in three hospital dermatology departments, 94 patients with CDN affecting the helix and antihelix were contacted by postal questionnaire at least 6 months after surgery. Replies were received from 77; 11 patients had died and six could not be traced. The main outcome measure was the identification of those patients in remission and those with disease recurrence. Sixty-two helix lesions were followed up for a mean of 52 months (range 8-99). There was recurrence in 10 patients (all men; 16%). Twenty antihelix lesions were followed up for a mean of 55 months (range 8-93). There was recurrence in five patients (all women; 25%). In conclusion, this study confirms that only cartilage needs to be excised for the long-term effective treatment of CDN. The only relevant aetiological factor identified was that all except one patient slept on the same side as the CDN. We believe that pressure on the ear during sleep causes CDN. This is most evident on the most protuberant part of the ear.