Darkening Lesion on the Ear: Why Early Evaluation Matters
Village Dermatology | Katy & Houston, Texas
A changing skin lesion should never be ignored—especially when it appears on sun-exposed areas like the ears. At Village Dermatology, we frequently evaluate concerning skin lesions to ensure early diagnosis and appropriate management.
In today’s case report, we highlight the evaluation and biopsy of a darkly pigmented lesion on the ear in an established patient.
Patient Presentation
A 58-year-old female presented to our dermatology clinic with concerns about a skin lesion on the right ear. She reported that the lesion had been present for several months and had gradually become darker, larger, and more irregular in appearance. The lesion had not been treated previously.
Because of the lesion’s location and changes over time, the patient was seen for prompt evaluation and management.
Dermatologic Examination
A focused skin examination was performed, including evaluation of the scalp, face, and upper extremities. The patient appeared well-developed, well-nourished, and in no acute distress.
Using dermatoscopy, a darkly pigmented macule was identified on the right antihelix of the ear. Dermatoscopic examination allows dermatologists to better assess pigment patterns and structural features that are not visible to the naked eye.
Clinical Impression and Differential Diagnosis
Based on the lesion’s appearance and evolution, the clinical impression was:
Neoplasm of Unspecified Behavior
The differential diagnosis included:
Neoplasm of unspecified behavior
Chondrodermatitis nodularis helicis (CNH)
Cyst
Given the uncertainty and concerning features, a biopsy was recommended to obtain a definitive diagnosis.
Procedure: Punch Biopsy of the Ear
After discussing risks and benefits, written informed consent was obtained. The biopsy was performed as follows:
Location: Right antihelix
Anesthesia: 1% lidocaine with epinephrine
Technique: 4 mm punch biopsy
Specimen: Sent for histopathologic evaluation (H&E staining)
Closure: 5-0 fast-absorbing gut suture
The patient tolerated the procedure well. Petrolatum and a bandage were applied, and detailed post-procedure care instructions were provided.
Follow-Up and Importance of Biopsy
The patient was advised that she would be notified of the biopsy results and instructed to contact the office if results were not received within two weeks.
This case highlights the importance of early dermatologic evaluation for lesions that are changing in color, size, or shape—particularly in sun-exposed areas like the ears. A simple in-office biopsy can provide critical information and peace of mind.
When to See a Dermatologist
You should schedule a dermatology appointment if you notice:
A mole or lesion that is darkening or enlarging
Irregular borders or uneven color
Lesions on sun-exposed areas such as the ears, face, or scalp
Any skin spot that looks or feels “different”
At Village Dermatology, we proudly serve patients in Katy, Houston, and surrounding Texas communities, offering expert skin cancer screening and personalized dermatologic care.
