A nodule on the ear rarely escapes attention. Discovery is usually made by the patient, who is worried about cancer, or by the physician, who can use the nodule to identify another disease. The chalky urate deposits in the gouty tophus (Figure, left), and the subcutaneous nodule of rheumatic fever (Figure, center) reflect visible evidence of generalized disease well known to all physicians. Microscopic examination will provide a diagnosis in questionable cases, as well as identify carcinoma when suspected.
Pain is notably absent from all nodules of the ear, except one. Painful nodule of the ear, formerly called nodular chondrodermatitis (Figure, right), is an uncommon disorder which is characterized by exquisite tenderness far out of proportion to its insignificant appearance. The nodule is located in the skin, and cartilage is only secondarily affected, if at all. A compromised blood supply is probably responsible for the lesion, but the exact nature