Normolipemic xanthomas on the ears of an adolescent

Abstract

To the Editor: A 15-year-old healthy black female reported a 1-year history of occasionally painful ear nodules. She denied antecedent trauma. Examination revealed multiple flesh-colored papules and nodules on the bilateral helices ranging in size from 0.5 to 2.7 cm (Figs 1 and 2). One nodule in the threshold of the left auditory canal caused a hearing deficit, which was corrected by pulling down on the earlobe. Family history was significant for keloids. Clinical differential diagnosis included epidermal cysts, lipomas, pseudocysts of the auricle, traumatic auricular hematoma (cauliflower ear), and angiolymphoid hyperplasia.