Topical nitroglycerin: a promising treatment option for chondrodermatitis nodularis helicis.

BACKGROUND: Chondrodermatitis nodularis helicis (CNH) is a painful nodule that often interferes with sleep and occurs on the helix or antihelix of the ear in older patients. Although several case reports describe a variety of seemingly effective surgical and conservative treatment options, well-studied treatment modalities have varying efficacy rates and can often demonstrate disappointing results.

OBJECTIVES: The purpose of this study was to evaluate the efficacy of 2% topical nitroglycerin for the treatment of CNH.

METHODS: A retrospective chart review was performed in 12 patients given the diagnosis of CNH who received 2% topical nitroglycerin twice daily for therapy. Therapeutic efficacy was determined by identifying improvement in the appearance and symptomatology of the lesion.

RESULTS: A total of 13 lesions in 12 patients were treated, with 12 (92%) lesions demonstrating improvement with the use of topical nitroglycerin. Eight of 13 (61.5%) CNH lesions developed complete clearance and resolution of symptoms, requiring no further treatment. Four of 13 (30.8%) lesions were found to have only symptomatic improvement, and these patients continued to use the ointment as needed. One of 12 (8.3%) patients found no benefit with the treatment but had also failed multiple other treatments modalities.

LIMITATIONS: Limitations include the small number of patients treated and the retrospective nature of the study.

CONCLUSIONS: Topical nitroglycerin demonstrated efficacy in treating both the symptoms and lesional appearance of CNH in a noninvasive manner, with an overall success rate that is comparable with other published methods.