23year lady having growth over the left ear lobe for the last 5 years.Gragually increasing in size and attained the present size.Her ear lobe was pricked in child hood. Local exam:Growth Size 2x2x1.5cm.Surface is bosselated., Sessile.Fixed to the pinna,firm to hard in consistency.Skin over the swelling can't be pinched.Non tender to touch.Opposite ear normal inspite of ear pricks.No neck nodes. Clinically Keloid Issues Should it be excised? Anticipating a raw surface post excision.Will a skin graft be accepted over that raw surface created post excision? If yes how and if no why?


This clinically looks,Keloid , most importantly needs preoperative councelling regarding the recurrence. Such a long standing keloid- i will go for intralesional excision preserving the edges and simultaneous intralesional kenacort at time of excision and than 3 weekly for 5-7 times. If defect is there it will require full thickness skin geaft instead of flap as flap will be bulky over the posterior auricular region where the skin is very thin . Of ut most importance is the uneventful wound healing of the excision procedure Along with pressure( from clip earings ) and massage should be done religiously after 3 weeks of excision. Radiation has still no established role, Even after that One should be ready for a recurrence
It looks condroma.. arising from ear cartilage. It cannot be excised completely. Some cartilage remains there and hence the high chances of recurrence. patient should be warned about the high recurrence prior to treatment. intralesional kenacort should be tried first. If no response and pt knows about recurrence then only excision. no need of graft. 3 mm surrounding skin thickness will cover the wound.
Most of doctors above mentioned that it is keloid and suggested treatment of keloid. One must defferenciate between condroma. . A benign growth arising from ear cartilage and keloid which is skin condition. keloid doesn't involve cartilage. pathologist can comment on this view. Thank you all.
Intralesional steroid is the TOC.. give every 4 wk for 4-6 mnths... superficial radiation for remaining lesion... excision is last option.. excision should be intralesional.. reconstruction according to size and floor of defect
Saurabh Hi! Can a skin graft get accepted over raw area over the back earlobe?is my concern

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Avoid skin grafts, you may have two keloids, local recurrence and skin graft donor site. Intralesional Excision with CO2 laser and primary closure, topical and inj steroids can help. Recurrence is rule
Dr Nitin Turaskar, your concern about coverage, Don't damage peri condrium as it will provide blood supply to graft and shape of the pinna will be maintained
Most likely it's chondroma. Can be excised preserving the shape of the pinna results are good, but recurrence should be in mind.
I am agree with you
The swelling looks like implantation dermoid. Excision and primary skin closure can be done.
It is a implantation dermoid since it follows ear prick. Excision advised
It's Implantation Dermoid
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