Spectacle granuloma

This is a lesion that arises due to pressure from a spectacle frame.

Presentation is with:

• a nodule on the posterior aspect of the helix
• there is a central groove in the nodule; this may ulcerate

Differential diagnosis

• basal cell carcinoma

Management

• generally requires specialist review regarding confirmation of diagnosis and treatment plan treatment
• options for chondrodermatitis nodularis include:
  • no intervention/pressure relief chondrodermatitis nodularis helicus is benign and so only those who suffer pain require treatment (1)
    • once diagnosis is confirmed - adjustment of spectacles so that the pressure is taken off the nodule
  • topical treatment options include lignocaine gel applied before retiring to bed and potent topical steroid ointments
  • steroid injections into the nodule may lead to prolonged improvement in about one third of patients (1)
• surgery
  • excision of the papule and a sliver of the cartilage beneath and adjacent

Click for an example image of this condition

Reference:

• Dermatology in Practice 2004; 12 (2): 28-30.
• GP (16/4/99), 63.