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Cutaneous lesions of the external ear.

Sand M, Sand D, Brors D, Altmeyer P, Mann B, Bechara FG - Head Face Med (2008)

Bottom Line: Skin diseases on the external aspect of the ear are seen in a variety of medical disciplines.Dermatologists, othorhinolaryngologists, general practitioners, general and plastic surgeons are regularly consulted regarding cutaneous lesions on the ear.This article will focus on those diseases wherefore surgery or laser therapy is considered as a possible treatment option or which are potentially subject to surgical evaluation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General and Visceral Surgery, Augusta Kranken Anstalt, Academic Teaching Hospital of the Ruhr-University Bochum, Germany. michael.sand@ruhr-uni-bochum.de

ABSTRACT
Skin diseases on the external aspect of the ear are seen in a variety of medical disciplines. Dermatologists, othorhinolaryngologists, general practitioners, general and plastic surgeons are regularly consulted regarding cutaneous lesions on the ear. This article will focus on those diseases wherefore surgery or laser therapy is considered as a possible treatment option or which are potentially subject to surgical evaluation.

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Lentigo maligna melanoma. Irregular pigmented and bordered, brown to black macule with visible bright to reddish regression zone.
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Figure 7: Lentigo maligna melanoma. Irregular pigmented and bordered, brown to black macule with visible bright to reddish regression zone.

Mentions: A prolonged radial growth phase is characteristic for Lentigo maligna melanoma. A study by Koh et al showed that 8.3% of all head and neck lentigo maligna melanomas occur on the ear [67]. It begins as a macular lesion with a variable pigmentation with an uneven irregular border which shows a sudden increase in size, induration and darkening of the lesion (Fig. 7). The most aggressive melanoma type is the nodular variant, which is a rapidly growing dark pigmented nodule which invades the dermis early in the disease course. The thin layer of subcutaneous tissue contributes to the distinctive invasiveness and therefore bad prognosis for melanoma on the ear. Key pathologic prognostic features of auricular melanomas include the histological subtype, tumor thickness, level of invasion and presence of ulceration. Jahn et al. showed that age, locality, tumour thickness, histological type, level of invasion and excision margins to be significant risk factors for local recurrence [68]. Nevertheless the overall survival of patients with melanoma on the ear depended only on the tumour thickness and Clark level of invasion. Therapy is a surgical approach and in some instances adjuvant therapy. Recommended excision margins are 10–20 mm for primary nodular melanoma (NM) or superficial spreading melanoma (SSM) and 5 mm with complete threedimensional histology of excision margins (3D histology) for lentigo maligna melanoma (LMM). The World Health Association requires a safety margin of 5 mm for melanoma in situ and 20 mm for melanoma which are >2.1 mm in vertical thickness. Recent studies have shown that margins > 10 mm have the lowest risk of recurrence [68]. In recent years the more aggressive surgical approach has changed towards narrower excision margins as it has been shown to have only an effect on the incidence of local recurrence and only little impact on disease specific survival.


Cutaneous lesions of the external ear.

Sand M, Sand D, Brors D, Altmeyer P, Mann B, Bechara FG - Head Face Med (2008)

Lentigo maligna melanoma. Irregular pigmented and bordered, brown to black macule with visible bright to reddish regression zone.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2267455&req=5

Figure 7: Lentigo maligna melanoma. Irregular pigmented and bordered, brown to black macule with visible bright to reddish regression zone.
Mentions: A prolonged radial growth phase is characteristic for Lentigo maligna melanoma. A study by Koh et al showed that 8.3% of all head and neck lentigo maligna melanomas occur on the ear [67]. It begins as a macular lesion with a variable pigmentation with an uneven irregular border which shows a sudden increase in size, induration and darkening of the lesion (Fig. 7). The most aggressive melanoma type is the nodular variant, which is a rapidly growing dark pigmented nodule which invades the dermis early in the disease course. The thin layer of subcutaneous tissue contributes to the distinctive invasiveness and therefore bad prognosis for melanoma on the ear. Key pathologic prognostic features of auricular melanomas include the histological subtype, tumor thickness, level of invasion and presence of ulceration. Jahn et al. showed that age, locality, tumour thickness, histological type, level of invasion and excision margins to be significant risk factors for local recurrence [68]. Nevertheless the overall survival of patients with melanoma on the ear depended only on the tumour thickness and Clark level of invasion. Therapy is a surgical approach and in some instances adjuvant therapy. Recommended excision margins are 10–20 mm for primary nodular melanoma (NM) or superficial spreading melanoma (SSM) and 5 mm with complete threedimensional histology of excision margins (3D histology) for lentigo maligna melanoma (LMM). The World Health Association requires a safety margin of 5 mm for melanoma in situ and 20 mm for melanoma which are >2.1 mm in vertical thickness. Recent studies have shown that margins > 10 mm have the lowest risk of recurrence [68]. In recent years the more aggressive surgical approach has changed towards narrower excision margins as it has been shown to have only an effect on the incidence of local recurrence and only little impact on disease specific survival.

Bottom Line: Skin diseases on the external aspect of the ear are seen in a variety of medical disciplines.Dermatologists, othorhinolaryngologists, general practitioners, general and plastic surgeons are regularly consulted regarding cutaneous lesions on the ear.This article will focus on those diseases wherefore surgery or laser therapy is considered as a possible treatment option or which are potentially subject to surgical evaluation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of General and Visceral Surgery, Augusta Kranken Anstalt, Academic Teaching Hospital of the Ruhr-University Bochum, Germany. michael.sand@ruhr-uni-bochum.de

ABSTRACT
Skin diseases on the external aspect of the ear are seen in a variety of medical disciplines. Dermatologists, othorhinolaryngologists, general practitioners, general and plastic surgeons are regularly consulted regarding cutaneous lesions on the ear. This article will focus on those diseases wherefore surgery or laser therapy is considered as a possible treatment option or which are potentially subject to surgical evaluation.

Show MeSH
Related in: MedlinePlus