Why is complete destruction of the epidermis dangerous

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As a result of recurring chondritis persisting deformities of the ears' cartilage can remain Fig. Polychondritis recidivans. Visible deformity of the ears cartilage, resulting from recurrent chondritis. Lupus vulgaris is a persistent form of cutaneous tuberculosis which potentially involves the ear. Lesions are sharply defined and brown, with a gelatinous consistency on erythematous base Fig. Therapy is a combination of antibiotics isoniazid, rifampicin, pyrazinamide and ethambutol given over a period of several months, and surgical excision of necrotic tissue.

As tuberculosis is enjoying a renaissance in western countries the incidence of cutaneous tuberculosis will increase in the future. Cutaneous tuberculosis. Retroauricular located red, partially brownish plaque with smooth surface. Cylindroma is benign, solitary or group-like skin colored or light red, bulging, protuberand tumors with a flat, shining surface.

They are usually located at the head and neck turban tumor and can potentially involve the ear Fig. They most likely represent very primitive sweat gland tumors originating from eccrine or apocrine glands. Histologically they show apocrine, eccrine, secretory, and ductal features, and the exact cellular origin of cylindromas remains unknown. Although benign, malignant transformation cylindrocarcinoma has been reported, in which case surgical excision is the treatment of choice [ 77 ].

Numerous pink, red, and partially bluish, firm nodules, affecting the upper parts of the ear and spreading to the left cheek. The distribution and arrangement of tumor masses resemble a bunch of grapes.

As the skin of the external auditory canal shows a high concentration of ceruminal glands it is susceptible for this already very rare type of benign and malignant tumours.

Benign adnexal tumours include ceruminous adenomas and pleomorphic adenoma which are best treated by wide local excision [ 78 ]. Malignant adnexal tumours include adenoidcystic-, mucinous-, cylindro-, poro-, spiradeno and adenocarcinoma [ 79 - 81 ]. They should be treated by an initial aggressive wide en bloc surgical resection with a primary lateral or subtotal temporal bone resection stage dependent combined with a parotidectomy and neck dissection. Even in T1 tumours local resection is described to be not sufficient [ 82 ].

However due to their rarity, a further discussion of these individual tumors is beyond the scope of this article. The blue nevus is a variant of a common benign mole which can be clinically misdiagnosed as a melanoma. The lesion is a gray blue to dark blue, smooth surfaced macule which is composed of melanocytes.

When multiple blue nevi are located at the head and neck Carney's syndrome, a rare association of blue nevi with hypercortisolism and a variety of nonendocrine myxomas and endocrine tumors should be considered Fig. Solitary, stable lesions can be observed.

A changing pigmented lesion should be biopsied to rule out the differential diagnosis of a malignant melanoma. Multiple blue naevus: Multiple, gray to blue, pinhead-sized macules affecting the external ear. If multiple blue naevi appear at the head and neck, remind that rare syndromes e.

Carney's syndrome may be causal. Auricular appendages are themselves harmless lesions Fig. In very rare cases they can be cutaneous manifestation of a complex disease. Surgical therapy is only done according to a specific wish of the patient. Auricular appandage: Dome-shaped, flesh-colored nodule with smooth surface at the upper part of the tragus. Osler-Weber-Rendu Disease Hereditary hemorrhagic teleangiectasia is an autosomal dominant disease which manifests itself with multiple punctuate hemangiomas and telangiectases Fig.

Additional characteristics are epistaxis and mucocutaneous visceral arteriovenous malformations. Laser therapy with a long-pulsed Nd:YAG laser, flash-pumped dye laser, or an intense pulsed light IPL system has been described as effective.

Osler-Weber-Rendu Disease. Multiple, punctuate, red macules and papules corresponding to hemangiomas and telangiectases. The outer ear with the auricle and ear canal can be affected by a variety of different skin lesions and dermatologic conditions. They can be either solitary lesions which are locally limited to the ear or are part of a generalized dermatologic condition.

They can afflict skin, cartilage, glands, vessels and hair follicles of the outer ear. The outer ear itself plays a functional role in audition by collecting and transmitting sound. Additionally it has an important effect on facial appearance and therefore on the individual psychological disposition.

Although the auricles skin macroscopically shares the anatomy and physiology of the bodys skin it shows some histological differences compared to the rest of the bodys skin. This specific anatomical peculiarities should be considered when treating skin lesions on the ear. In cloncusion, the authors suggest that an interdisciplinary approach that combines surgery, dermatology and otolaryngology can provide optimal care for the patient.

The most common skin diseases of the outer ear which are potentially subject of surgical or laser therapy have been described briefly in this review.

MS: Documented and prepared the draft. DS: Edited the manuscript, revision of bibliography and helped in preparing the draft. DB: Revised and edited the manuscript. PA: Literature search, and helped with editing of the manuscript. BM: Revised the manuscript, literature search. FGB: Helped in preparing the draft and edited most of the manuscript. All authors read and approved the final manuscript. National Center for Biotechnology Information , U.

Journal List Head Face Med v. Head Face Med. Published online Feb 8. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Michael Sand: ed. Received Sep 27; Accepted Feb 8. This article has been cited by other articles in PMC. Abstract Skin diseases on the external aspect of the ear are seen in a variety of medical disciplines.

Anatomical characteristics When evaluating skin lesions on the ear, specific anatomical peculiarities should be considered. Epithelial tumors of the external ear Non-malignant tumors Seborrhoic keratosis Syn. Open in a separate window. Figure 1. Atheroma Syn. Granuloma fissuratum Syn. Figure 2. Pre-neoplasia Actinic keratoses Syn. Cutaneous Horn Syn.

Figure 3. Bowens disease Syn. Squamous cell carcinoma Squamous cell carcinoma SCC can arise anywhere on the outer ear and potentially involves the middle ear and the lateral skull base. Figure 4. Non-epithelial tumors of the external ear Non-malignant tumors Keloid Keloid is first described in the Smith Papyrus from ancient Egypt [ 45 ]. Figure 5. Pre-neoplasia Lentigo maligna Syn.

Malignant tumours Melanoma Syn. Figure 6. Figure 7. Inflammatory lesions Winkler Disease Syn. Figure 8. Lymphocytoma Syn. Figure 9. Visible intensely red-violet swelling of the right earlobe. Infectious lesions Infectious lesions of the external ear are rarely subject to surgical intervention. Figure Rare Lesions Cylindroma Syn.

Adnexal Tumours Syn. Blue Nevus Syn. Conclusion The outer ear with the auricle and ear canal can be affected by a variety of different skin lesions and dermatologic conditions. Competing interests The author s declare that they have no competing interests.

Authors' contributions MS: Documented and prepared the draft. Acknowledgements The written consent was obtained from the patients. Irritated seborrheic keratosis of the external ear canal. Pathol Int. Seborrhoeic keratosis or occult malignant neoplasm of the skin? Eur Acad Derm Venereol. Seborrheic keratosis. In: Rosai J, editor. Removal of keratinous and pilar cysts with the punch incision technique: analysis of surgical outcomes. Related questions Is dry skin a deficiency symptom of vitamin A?

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