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

Engel D. Pseudocysts of the auricle in Chinese. Arch Otolaryngol. 1966 Mar. 83(3):197-202. [QxMD MEDLINE Link].
Beutler BD, Cohen PR. Pseudocyst of the auricle in patients with movement disorders: report of two patients with ataxia-associated auricular pseudocysts. Dermatol Pract Concept. 2015 Oct 31. 5 (4):59-64. [QxMD MEDLINE Link]. [Full Text].
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. [QxMD MEDLINE Link].
Miyamoto H, Okajima M, Takahashi I. Lactate dehydrogenase isozymes in and intralesional steroid injection therapy for pseudocyst of the auricle. Int J Dermatol. 2001 Jun. 40(6):380-4. [QxMD MEDLINE Link].
Chen PP, Tsai SM, Wang HM, Wang LF, Chien CY, Chang NC, et al. Lactate dehydrogenase isoenzyme patterns in auricular pseudocyst fluid. J Laryngol Otol. 2013 May. 127(5):479-82. [QxMD MEDLINE Link].
Kopera D, Soyer HP, Smolle J, Kerl H. "Pseudocyst of the auricle", othematoma and otoseroma: three faces of the same coin?. Eur J Dermatol. 2000 Aug. 10(6):451-4. [QxMD MEDLINE Link].
Stankevice D, Nielsen KO. [Two cases of auricular pseudocyst]. Ugeskr Laeger. 2009 Mar 9. 171(11):907. [QxMD MEDLINE Link].
Glamb R, Kim R. Pseudocyst of the auricle. J Am Acad Dermatol. 1984 Jul. 11(1):58-63. [QxMD MEDLINE Link].
Ng W, Kikuchi Y, Chen X, Hira K, Ogawa H, Ikeda S. Pseudocysts of the auricle in a young adult with facial and ear atopic dermatitis. J Am Acad Dermatol. 2007 May. 56(5):858-61. [QxMD MEDLINE Link].
Devlin J, Harrison CJ, Whitby DJ, David TJ. Cartilaginous pseudocyst of the external auricle in children with atopic eczema. Br J Dermatol. 1990 May. 122(5):699-704. [QxMD MEDLINE Link].
Pereira FC, Chinelli PA, Takahashi MD, Nico MM. Bilateral pseudocyst of the auricle in a man with pruritus secondary to lymphoma. Int J Dermatol. 2003 Oct. 42(10):818-21. [QxMD MEDLINE Link].
Lai WS, Wang CH, Shih CP. Bilateral auricular pseudocyst. Arthritis Rheum. 2013 Apr. 65 (4):1084. [QxMD MEDLINE Link]. [Full Text].
Tan BY, Hsu PP. Auricular pseudocyst in the tropics: a multi-racial Singapore experience. J Laryngol Otol. 2004 Mar. 118(3):185-8. [QxMD MEDLINE Link].
Kanotra SP, Lateef M. Pseudocyst of pinna: a recurrence-free approach. Am J Otolaryngol. 2009 Mar-Apr. 30(2):73-9. [QxMD MEDLINE Link].
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. [QxMD MEDLINE Link].
Lim CM, Goh YH, Chao SS, Lim LH, Lim L. Pseudocyst of the auricle: a histologic perspective. Laryngoscope. 2004 Jul. 114(7):1281-4. [QxMD MEDLINE Link].
Lazar RH, Heffner DK, Hughes GB, Hyams VK. Pseudocyst of the auricle: a review of 21 cases. Otolaryngol Head Neck Surg. 1986 Mar. 94(3):360-1. [QxMD MEDLINE Link].
Hoffmann TJ, Richardson TF, Jacobs RJ, Torres A. Pseudocyst of the auricle. J Dermatol Surg Oncol. 1993 Mar. 19(3):259-62. [QxMD MEDLINE Link].
Abdel Tawab HM, Tabook SMS. Incision and Drainage with Daily Irrigation for the Treatment of Auricular Pseudocyst. Int Arch Otorhinolaryngol. 2019 Apr. 23 (2):178-183. [QxMD MEDLINE Link]. [Full Text].
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. [QxMD MEDLINE Link]. [Full Text].
Job A, Raman R. Medical management of pseudocyst of the auricle. J Laryngol Otol. 1992 Feb. 106(2):159-61. [QxMD MEDLINE Link].
Miyamoto H, Oida M, Onuma S, Uchiyama M. Steroid injection therapy for pseudocyst of the auricle. Acta Derm Venereol. 1994 Mar. 74(2):140-2. [QxMD MEDLINE Link].
Kim TY, Kim DH, Yoon MS. Treatment of a recurrent auricular pseudocyst with intralesional steroid injection and clip compression dressing. Dermatol Surg. 2009 Feb. 35(2):245-7. [QxMD MEDLINE Link].
Patigaroo SA, Mehfooz N, Patigaroo FA, Kirmani MH, Waheed A, Bhat S. Clinical characteristics and comparative study of different modalities of treatment of pseudocyst pinna. Eur Arch Otorhinolaryngol. 2011 Oct 29. [QxMD MEDLINE Link].
Lim CM, Goh YH, Chao SS, Lynne L. Pseudocyst of the auricle. Laryngoscope. 2002 Nov. 112(11):2033-6. [QxMD MEDLINE Link].
Khan NA, Ul Islam M, Ur Rehman A, Ahmad S. Pseudocyst of pinna and its treatment with surgical deroofing: an experience at tertiary hospitals. J Surg Tech Case Rep. 2013 Jul. 5(2):72-7. [QxMD MEDLINE Link]. [Full Text].
Salgado CJ, Hardy JE, Mardini S, Dockery JM, Matthews MS. Treatment of auricular pseudocyst with aspiration and local pressure. J Plast Reconstr Aesthet Surg. 2006. 59(12):1450-2. [QxMD MEDLINE Link].
Oyama N, Satoh M, Iwatsuki K, Kaneko F. Treatment of recurrent auricle pseudocyst with intralesional injection of minocycline: a report of two cases. J Am Acad Dermatol. 2001 Oct. 45(4):554-6. [QxMD MEDLINE Link].
Cohen PR, Katz BE. Pseudocyst of the auricle: successful treatment with intracartilaginous trichloroacetic acid and button bolsters. J Dermatol Surg Oncol. 1991 Mar. 17(3):255-8. [QxMD MEDLINE Link].
AlGhamdi KM, AlEnazi MM. Versatile punch surgery. J Cutan Med Surg. 2011 Mar-Apr. 15(2):87-96. [QxMD MEDLINE Link].
Han A, Li LJ, Mirmirani P. Successful treatment of auricular pseudocyst using a surgical bolster: a case report and review of the literature. Cutis. 2006 Feb. 77(2):102-4. [QxMD MEDLINE Link].
Cohen PR. Successful treatment of auricular pseudocyst using a surgical bolster. Cutis. 2007 Oct. 80(4):274. [QxMD MEDLINE Link].
Shan Y, Xu J, Cai C, Wang S, Zhang H. Novel Modified Surgical Treatment of Auricular Pseudocyst Using Plastic Sheet Compression. Otolaryngol Head Neck Surg. 2014 Sep 12. [QxMD MEDLINE Link].

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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