Derm Cases · Dermatology / ENT
OSCE — painful helix nodule and sleep-side ear pain
OSCE: diagnose CNH, plan pressure relief and adjuncts, counsel differentials including cancer and RP.
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Study tools
Target exams
NEET-PGINICETPLABMRCP
Prompt
OSCE: diagnose CNH, plan pressure relief and adjuncts, counsel differentials including cancer and RP.
Brief (to candidate)
A 65-year-old man has a small tender nodule on the right helix that wakes him when he lies on that side. Diagnose, manage, and safety-net.
Candidate instructions
- Focused history (sleep side, trauma, systemic features).
- Working diagnosis and differentials.
- Immediate non-drug measures.
- Medical/procedural options if refractory.
- Red flags for RP and keratinocyte cancer.
Examiner checklist
| Domain | Key actions expected |
|---|---|
| Diagnosis | CNH for sleep-side tender helix nodule[1] |
| Core Rx | Pressure offloading explained specifically[2] |
| Adjuncts | Topical/intralesional/procedural ladder if needed |
| DDx safety | Atypical/non-healing → biopsy; lobe-sparing red pinna + systemic → RP concern[5] |
| Communication | Benign pressure disease vs when to return |
Model key actions
- Name CNH; prescribe a real pressure plan, not only a cream.[1][2]
- Mention cancer biopsy threshold and RP lobe-sparing contrast.[5]
Common errors
- Jumping to excision without offloading.
- Calling all red ears cellulitis.
- Missing cancer in atypical nodules.
References3ShowHide
- [1]Zhang LW, et al. Chondrodermatitis nodularis helicis. Cleve Clin J Med, 2023.PMID 37263665
- [2]Shah S, et al. Chondrodermatitis nodularis helicis: A review of current therapies. Dermatol Ther, 2017.PMID 27723195
- [5]Karp NC, et al. Ear Swelling of Relapsing Polychondritis. J Gen Intern Med, 2023.PMID 36854868