At a glance - Actinic keratosis of ear vs chondrodermatitis nodularis

Diagnosis and management of actinic keratosis and chondrodermatitis nodularis. By Dr Vasa Gnanapragasam.

ACTINIC KERATOSIS

Discriminatory signs

  • Precancerous skin growth usually caused by sun exposure.
  • Most common in the elderly and young individuals with fair skin.
  • Flat red, brown, or skin-coloured scaly lesions areas that later develop a hard wart-like surface or rough and sandpapery.
  • Common on sun-exposed areas such as face, scalp and chest.
  • If untreated, 1 per cnt develop squamous cell carcinoma.

Management

  • Cryotherapy.
  • Curettage and electrosurgery.
  • Topical 5% fluorouracil or imiquimod.
  • Minimize sun exposure and protect skin from the sun. Wear protective clothing and avoid midday exposure.
  • Use high-quality sunscreens.
  • Sunscreen for winter exposure.

CHONDRODERMATITIS NODULARIS

Discriminatory signs

  • Non-cancerous painful inflammation of the cartilage caused by pressure on the skin.
  • Usually affects middle-aged or elderly men.
  • Nodules grow to about 6mm.
  • Round or oval, slightly raised, with scaly or crusty surface.
  • Central core which may discharge a small amount of scaly material.
  • Right ear is affected more often than the left.
  • Common and harmless, but painful.

Management

  • Corticosteroid cream or steroid injection.
  • Antibiotic cream if ulcerated.
  • Cryotherapy/excision.
  • Avoid excessive exposure to cold and sun.
  • 10 -30 per cent recurrence rate after surgery.
Dr Vasa Gnanapragasam, GP in Sutton, Surrey

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