Imaging Studies

In several reports, magnetic resonance images revealed a serous fluid collection within the auricular cartilage, further enhancing the diagnosis.^{[11, 15]}

Histologic Findings

Histologically, pseudocysts of the auricle lack pathognomonic features, but they can typically be characterized by an intracartilaginous cavity lacking an epithelial lining. They contain thinned cartilage and hyalinizing degeneration along the internal border of the cystic space. The epidermis and dermis overlying the pseudocyst are usually normal. However, a dermal perivascular lymphocytic infiltrate is commonly found, along with inflammatory cells within the cystic space.

In one of study, calcification of the auricular cartilage was identified at least 7 days after initial clinical presentation.^[16]Although contrary to literature reports,^{[8, 17, 18]}one study postulated that an inflammatory response is crucial to the development of pseudocysts. This theory is based on a consistent perivascular inflammatory response seen in all 16 specimens studied.^[16]Eosinophilic degeneration and necrosis of the cartilage is also present in some areas.^[15]Intracartilaginous fibrosis and granulation tissues are manifestations of later stages of pseudocysts.^[16]A slide of an auricular pseudocyst is shown below.

Low magnification of this pseudocyst reveals a mucin-containing cystic cavity.

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Treatment & Management

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Dutsch-Wicherek M, Trzebuniak I, Szymońska I, Młynarski D, Kobos J, Wicherek Ł, et al. Bilateral pseudocyst of the auricles in a 4-week neonate-case report and world literature review. Int J Pediatr Otorhinolaryngol. 2019 Jul. 122:1-5. [Medline].
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Tuncer S, Basterzi Y, Yavuzer R. Recurrent auricular pseudocyst: a new treatment recommendation with curettage and fibrin glue. Dermatol Surg. 2003 Oct. 29(10):1080-3. [Medline].
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Cader SHA, Shah FA, Reghunandanan Nair SKG. Clinico-pathological profile and comparative study of conservative versus surgical deroofing as an effective technique in management of pseudocyst of pinna. World J Otorhinolaryngol Head Neck Surg. 2018 Dec. 4 (4):234-239. [Medline]. [Full Text].
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Media Gallery

Asymptomatic nodule on the left ear.
Low magnification of this pseudocyst reveals a mucin-containing cystic cavity.

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Author

William P Baugh, MD Assistant Clinical Professor of Dermatology, Western University of Health Sciences; Medical Director, Full Spectrum Dermatology; Consulting Staff, Department of Dermatology, St Jude Medical Center

William P Baugh, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Laser Medicine and Surgery, Christian Medical and Dental Associations

Disclosure: Nothing to disclose.

Coauthor(s)

Cynthia C Lazzaro, DO Physician

Cynthia C Lazzaro, DO is a member of the following medical societies: American Academy of Dermatology, American Osteopathic College of Dermatology

Disclosure: Nothing to disclose.

Natalie Ana Baugh California State University, Long Beach

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Edward F Chan, MD Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Kelly M Cordoro, MD Assistant Professor of Clinical Dermatology and Pediatrics, Department of Dermatology, University of California, San Francisco School of Medicine

Kelly M Cordoro, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Medical Society of Virginia, Society for Pediatric Dermatology, Women's Dermatologic Society, Association of Professors of Dermatology, National Psoriasis Foundation, Dermatology Foundation

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Mark L. Welch, MD, and Hon Pak, MD, to the development and writing of this article.

	Pseudocyst of the auricle	Chondrodermatitis chronica helices	Relapsing polychondritis	Subperichondrial hematoma
Swelling	Localized	Localized	Diffuse	Localized
Skin involvement	Rare	Yes, crusting/ulceration	Yes, erythematous	Rare
Pain	Rare	Common (from ulceration)	Common (extremely tender)	Common
Systemic Symptoms	No	No	Yes (involvement of other cartilage)	No
Histology	Intracartilaginous, cystic defect, granulation tissue	Subperichondrial granulation tissue, cystic dilatation rare	Acute inflammable cells seen; antibody deposition on basement membrane during immunofluorescence	Inflammatory cells with degraded blood products
Adapted from Lim CM, et al. “Pseudocyst of the Auricle.” 2002.

Pseudocyst of the Auricle Workup

Imaging Studies

Histologic Findings

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