Chondrodermatitis nodularis (CN) helicis—or, less frequently, antihelicis—is a painful benign lesion that usually affects patients between 50 and 70 years of age and is more common in men.1 The exact etiology of the process is unknown, although impairment of the vascular supply caused by repeated pressure on the region is the most widely accepted theory.

We report the case of a 54-year-old man who worked as a freight manager—an occupation that entails more than 6hours of mobile telephone use per day—and had no past medical history of interest. The patient had a painful lesion on the left auricle that had appeared nearly 1 year earlier. Physical examination revealed an ulcerated, erythematous, rounded, nodular lesion on the antihelix that was painful to touch and had relatively well-defined borders (Figs. 1 and 2). Histologic findings ruled out malignancy and were consistent with a diagnosis of CN. The patient said that he often held a mobile telephone against the site of the lesion for long periods while working. We therefore opted for a conservative approach and advised the patient to use a hands-free device. Clinical improvement was observed after 3 months. After 1 year of follow-up, complete resolution of the lesion was achieved and no recurrence was observed (Fig. 3).

Figure 1.

Ulcerated, erythematous, rounded, nodular lesion with relatively well-defined borders on the antihelix.

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Figure 2.

Lesion after skin biopsy.

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Figure 3.

Resolved lesion 1 year after the patient started using a hands-free device.

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The exact incidence of CN is unknown because the entity is not widely studied.2 Sustained pressure on the auricular region has been postulated as a mechanism of etiology and pathogenesis. Excessive telephone use can cause perichondrial vasculitis, which can lead to the degeneration of the auricular cartilage.3 The differential diagnosis should include neoplastic and preneoplastic lesions such as basal cell carcinoma, squamous cell carcinoma, and actinic keratoses; histologic examination is sometimes necessary to rule out these possibilities.4 The most widely used conservative treatments are pressure-relieving devices, topical or intralesional corticosteroids, topical nitroglycerine, and photodynamic therapy, and the efficacy of these techniques is highly variable.5–7 Narrow elliptical skin excision followed by the shaving of the affected underlying cartilage is among the most widely used surgical techniques and has cure rates of up to 90.4% for lesions on the helix and 62.5% for lesions on the antihelix.8 In the case of our patient, the use of a hands-free device to avoid recurrent trauma in the region was sufficient to cure the lesion.

We have presented a case of CN antihelicis caused by work-related mobile telephone use for many hours a day. Although this etiology is not reported frequently in the literature, physicians should take into account the widespread use of mobile telephones when trying to determine the cause of this dermatosis and prescribe treatment.