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Bilateral Pruritic Auricular Papules and Plaques


Am Fam Physician. 2016 Sep 15;94(6):486-489.

A 59-year-old woman presented with several years of persistent and worsening bilateral pruritic auricular lesions. The rash was limited to the ears, and the patient did not have a history of a similar rash on other areas of her body. She reported rubbing and scratching her ears often. A trial of ketoconazole shampoo and triamcinolone cream was ineffective.

Examination revealed cobblestoned, slightly keratotic, brown papules and plaques on the concave surfaces of both ears (Figure 1 and Figure 2). The physical examination was otherwise unremarkable. A punch biopsy of the plaque was performed.

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Figure 1.

Figure 1.

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Figure 2.

Figure 2.


Based on the patient's history and physical examination findings,

Address correspondence to Zachary Zinn, MD, at Reprints are not available from the authors.

Author disclosure: No relevant financial affiliations.


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1. Mahalingam M, Steinberg-Benjes L, Goldberg LJ. Primary amyloidosis of the auricular concha – a case report and review. J Cutan Pathol. 2000;27:564....

2. Mahalingam M, Palko M, Steinberg-Benjes L, Goldberg LJ. Amyloidosis of the auricular concha: an uncommon variant of localized cutaneous amyloidosis. Am J Dermatopathol. 2002;24(5):447–448.

3. Salim T, Shenoi SD, Balachandran C, Mehta VR. Lichen amyloidosus: a study of clinical, histopathologic and immunofluorescence findings in 30 cases. Indian J Dermatol Venereol Leprol. 2005;71(3):166–169.

4. Brownstein MH, Helwig EB. The cutaneous amyloidoses. I. Localized forms. Arch Dermatol. 1970;102(1):8–19.

5. MacSween RM, Saihan EM. Nylon cloth macular amyloidosis. Clin Exp Dermatol. 1997;22(1):28–29.

6. Weyers W, Weyers I, Bonczkowitz M, Diaz-Cascajo C, Schill WB. Lichen amyloidosus: a consequence of scratching. J Am Acad Dermatol. 1999;37(6):923–928.

7. Pourrabbani S, Marra DE, Iwasaki J, Fincher EF, Ronald LM. Colloid milium: a review and update. J Drugs Dermatol. 2007;6(3):293–296.

8. Prose NS, Von Knebel-Doeberitz C, Miller S, Miller PB, Meilman E. Widespread flat warts associated with human papillomavirus type 5: a cutaneous manifestation of human immunodeficiency virus infection. J Am Acad Dermatol. 1990;23(5 pt 2):978–981.

9. Ding CY, Liu H, Khachemoune A. Granular parakeratosis: a comprehensive review and a critical reappraisal. Am J Clin Dermatol. 2015;16(6):495–500.

This series is coordinated by John E. Delzell Jr., MD, MSPH, Assistant Medical Editor.

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