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Presented by Theresa Chan, M.D. and prepared by Maryam Farinola M.D.
Case 5: 9 month old female with ear lesion
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1. Question
Week 164: Case 5
9 month old female with ear lesionimages/traguslow2.jpg
images/tragusmed.jpg
images/tragusmed2.jpgCorrect
Answer: Accessory tragus
Histology: The lesion is a polypoid piece of skin with numerous hair follicles that are irregularly spaced. The core of the lesion consists of fibrofatty tissue with cartilage.
Discussion: Accessory tragi may be unilateral or bilateral nodules that are present in the preauricular area. The lesions are present at birth and represent a first branchial cleft anomaly. Rarely accessory tragi may be found in the neck; these cervical lesions are reported as cervical auricles and “wattles”. Although rare, they can be associated with other syndromees of the first branchial arch, such as oculoauriculovertebral syndrome (Goldenhar syndrome).
Accessory tragus is characterized by polypoid skin showing numerous small mature hair follicles and a fibrovascular zone under the epidermis. Usually the core of the lesion consists of adipose tissue and a core of cartilage. The presence of cartilage, however, is not essential. Of importance is the prominent connective tissue framework in the subcutaneous fat that seem to be one of the diagnostic criteria for accessory tragi.
Incorrect
Answer: Accessory tragus
Histology: The lesion is a polypoid piece of skin with numerous hair follicles that are irregularly spaced. The core of the lesion consists of fibrofatty tissue with cartilage.
Discussion: Accessory tragi may be unilateral or bilateral nodules that are present in the preauricular area. The lesions are present at birth and represent a first branchial cleft anomaly. Rarely accessory tragi may be found in the neck; these cervical lesions are reported as cervical auricles and “wattles”. Although rare, they can be associated with other syndromees of the first branchial arch, such as oculoauriculovertebral syndrome (Goldenhar syndrome).
Accessory tragus is characterized by polypoid skin showing numerous small mature hair follicles and a fibrovascular zone under the epidermis. Usually the core of the lesion consists of adipose tissue and a core of cartilage. The presence of cartilage, however, is not essential. Of importance is the prominent connective tissue framework in the subcutaneous fat that seem to be one of the diagnostic criteria for accessory tragi.
