The skin that covers the areas of the nose and ear has a number of characteristic qualities: its adherence to the layers below makes it difficult to lift in folds, it is rich in sebaceous glands and, in the case of the ear, also in sweat glands adapted for the secretion of wax. Furthermore, the anatomical position of the nose and ear and the purposes these two organs serve make them more susceptible to physical and traumatic events, while their visibility means that any lesions, regardless of their size, are of great aesthetic significance and can have major psychological repercussions. Clearly all types of tumour can occur in and around the nose and ear, however some neoplasms are more frequently found here because of the conditions mentioned above. The most frequent benign neoformations in these areas are: Seborrheic keratosis, trichofolliculoma, trichilemmoma, trichoepithelioma and fibrous papule of the nose. Angiomas also occur in these areas. Occurrences at paranasal, pre- and retro-auricular level are the most dangerous because of the possibility of large growths and secondary ulceration of the lesion, with serious aesthetic consequences. Elsewhere, this lesion grows more slowly because of the compression resulting from the low degree of skin extendibility. Because of their particular exposure to risk factors (UV rays and traumas), the nose and ear are often the scene of pre-cancerous (solar keratoses) and malignant tumours (basal cell and squamous cell epithelioma). Rarer forms of malignant tumour are also found in these areas. Adenocarcinoma of the ceruminous glands, which manifests itself with a blockage and earache. Annexial or sclerosant carcinoma of the sweat duct localised usually in the centre of the face, particularly in elderly women, as a subcutaneous nodule or a plate attached to the lower surfaces with clearly palpable edges. However, the edges do not correspond to the real edges of the neoplasm, which spreads to a much greater degree into the tissue below; for this reason surgical removal using the Mohs technique is always recommended. The trichilemmal carcinoma and the nasal natural killer/T cell lymphoma are considered typical tumours of these areas. It is also important to emphasise that for a correct diagnosis some lesions in these areas may take on the appearance of a tumour without being neoplasms: nasal glioma, branchial malformations, pseudocysts of the auricle, keloids, chondrodermatitis nodularis helicis and acanthoma fissuratum of the ears. Early diagnosis of the tumour, especially in these areas is particularly important if it is to be removed in time, and with the best aesthetic and functional results. In most cases surgical removal is the best treatment and, particularly in the case of benign forms, the histological examination is decisive.
|Translated title of the contribution||Neoplastic diseases of nose and ear|
|Title of host publication||Journal of Plastic Dermatology|
|Number of pages||6|
|Publication status||Published - Jan 2006|
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