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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1483- 01 March Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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Case History: 49 year old male with psoriasis who developed pain and swelling of the right ear helix 3 months ago.

Case posted by Dr Uma Sundram


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vincenzo polizzi

Posted

Yes...something like..I was thinking of a auricular chondritis caused by a piercing...there is a granulation tissue like with a zonal pattern, as if it was started from the cartilage

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Nitin Khirwadkar

Posted

Yes, looks like mixed inflammation/granulation tissue like picture, probably in keeping with (relapsing) polychondritis. Was this patient on TNF alpha inhibitors for the psoriasis? The latter can cause relapsing polychondritis.

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Relapsing polycondritis-like ear disease. Some lesions associated with Psoriasis do not fulfill the clinical criteria for relapsing polycondritis, that´s the reason some authors prefere the term above. This is also more associated with patients who presents with psoriatic arthritis.

http://www.jaad.org/article/S0190-9622(09)02290-7/pdf

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Raul Perret

Posted

Yes i was about to quote the same article. Should consider that diagnosis but CPC and follow-up of the patient is important as this could be the first manifestation of an evolving relapsing polycondritis

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Dr. Mona Abdel-Halim

Posted

Agree with relapsing polychondritis

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Agree with relapsing polychndritis 

Agree with Raul as CPC is required.

90% have involvement of auricular cartilage, mostly bilateral presenting with erythema and tenderness.

Ear lobes are usually spared.

Clinical diagnosis requires 3 of following:

1- Reccurrent chondritis of both auricles

2- None erosive inflammatory artheritis

3- Chondritis of nasal cartilage

4- Ocular inflammation such as conjunctivitis,keratitis,sceleritis,episceleritis or uveitis

5-chondritis of upper respiratory tract involving layrnx or tracheal cartilage

6-Cochlear or vestibular damage with sensoneural hearing loss,tinitus or vertigo

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Guest Romualdo

Posted

Agree with relapsing polychondritis.

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Uma Sundram

Posted

Relapsing polychondritis. Pt not on tnf alpha inhibitors.

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