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DOI 10.1002/art.37856
Clinical Images: Bilateral auricular pseudocyst

The patient, a 64-year-old woman, presented with a 4-month history of swelling of the left pinna (A) and later presented with a
1-month history of painless swelling of the right pinna (B). There was no history of recent trauma. In the 3 months prior to
presentation, saddlenose deformity, peripheral ulcerative keratitis, aphthous ulcers, and purpura developed, and the patient lost
weight. Physical examination revealed bilateral cystic swelling and mild tenderness of the auricles (with the exception of the lobules)
and severe deformity of the nasal bridge and septum. Incision and drainage were performed. Histologic examination of the auricular
cartilage showed fibrosis, with focal destruction and inflammation, adjacent to an irregular cystic space, consistent with relapsing
polychondritis. Results of tests for antineutrophil cytoplasmic antibodies were negative, and renal function was normal. The patient
was treated with glucocorticoids and azathioprine, and the auricular swelling resolved, with mild residual contracture of the
antihelix. Relapsing polychondritis is a rare autoimmune disease involving cartilaginous tissues, predominantly the ears and nose.
Auricular involvement occurs in ⬎80% of patients, usually associated with pain, swelling, redness, and tenderness, but the ear lobes
are usually not involved. Auricular pseudocyst is quite a rare manifestation of relapsing polychondritis.
Wen-Sen Lai, MD
Tri-Service General Hospital
National Defense Medical Center
Taipei, Taiwan
and Taichung Armed Forces General Hospital
Taichung, Taiwan
Chih-Hung Wang, MD, PhD
Cheng-Ping Shih, MD
Tri-Service General Hospital
National Defense Medical Center
Taipei, Taiwan