Clinical features of Relapsing Polychondritis
Clinical features and potential complications of the auricular and nasal chondritis of Relapsing Polychondritis
Auricular chondritis is the most frequent and characteristic clinical feature of RPC, eventually appearing in nearly 90% of patients. It typically presents as the sudden onset of burning pain, warmth, swelling, and purplish-red discoloration of the helix, antihelix, and sometimes tragus of one or both ears. Because only the cartilaginous portion is affected, the inferior soft lobules are always spared, separating it from cellulitis. Attacks may last from a few days to several weeks. Repeated inflammation may lead to cartilaginous calcification of the pinnas, which may be seen in other conditions such as frostbite. After one or more attacks, the external ear may lose its structural integrity owing to inflammatory dissolution of cartilage. This results in a drooping, floppy ear termed as “cauliflower ear”
Nasal chondritis develops suddenly as a painful fullness of the nasal bridge. It is less recurrent than auricular chondritis; however, even in the absence of clinical inflammation, cartilage collapse may occur resulting in a “saddle nose” deformity. Nasal chondritis is associated with airway involvement; its presence should prompt a computed tomography (CT) evaluation of the lungs.
