Auricular pseudocyst due to unusual repetitive manipulation of the ears : clinical approach

Laboratory testing, including blood count, general biochemistry, thyroid profile, uric acid, complement, autoantibody (e.g. anti-nuclear antibody and extractable nuclear antigen antibody) and proteinogram tests, indicated no abnormalities. Comment An auricular pseudocyst (AP) is a benign asymptomatic non-inflammatory lesion of unknown aetiology and variable size located in the helix or the triangular or scaphoid fossae of the ear.1,2 Both unilateral and bilateral APs have previously been described in the literature.2 A history of ear-related trauma, frequent use of headphones or contact sports such as rugby have been associated with APs.3 The differential diagnosis of this entity includes chondrodermatitis nodularis helicis, epidermal cysts, recurrent perichondritis and rheumatoid nodules.3 For injuries affecting the auricle, the differential diagnosis may be challenging; therefore, caution is required so as to subsequently guide appropriate treatment. Incision and drainage of APs is contraindicated, as there is a local recurrence rate of 100%.4 Intra-lesional injections of triamcinolone or sclerosing drugs, such as tetracycline or trichloroacetic acid, are considered the optimal choice of treatment.4–6 Surgical excision with local compression (i.e. using shirt buttons or mouldable thermoplastic tablets) also offers effective cosmetic and functional results.6,7 Overall, unnecessary procedures should be avoided so as to circumvent unanticipated complications, such as infection, auricular chondritis or related deformities.8 1.