Topical nitroglycerin: a promising treatment option for chondrodermatitis nodularis helicis

Chondrodermatitis nodularis helicis (CNH) is a painful nodule that often interferes with sleep and occurs on the helix or antihelix of the ear in older patients. Although several case reports describe a variety of seemingly effective surgical and conservative treatment options, well-studied treatment modalities have varying efficacy rates and can often demonstrate disappointing results.

The purpose of this study was to evaluate the efficacy of 2% topical nitroglycerin for the treatment of CNH.

A retrospective chart review was performed in 12 patients given the diagnosis of CNH who received 2% topical nitroglycerin twice daily for therapy. Therapeutic efficacy was determined by identifying improvement in the appearance and symptomatology of the lesion.

A total of 13 lesions in 12 patients were treated, with 12 (92%) lesions demonstrating improvement with the use of topical nitroglycerin. Eight of 13 (61.5%) CNH lesions developed complete clearance and resolution of symptoms, requiring no further treatment. Four of 13 (30.8%) lesions were found to have only symptomatic improvement, and these patients continued to use the ointment as needed. One of 12 (8.3%) patients found no benefit with the treatment but had also failed multiple other treatments modalities.

Limitations include the small number of patients treated and the retrospective nature of the study.

Topical nitroglycerin demonstrated efficacy in treating both the symptoms and lesional appearance of CNH in a noninvasive manner, with an overall success rate that is comparable with other published methods.