I just checked some photos and confirmed my suspicions that this is what one of my patients has, so am making some notes on the advice:
- Main thing is to avoid pressure on the ear during sleep. Cutting a hole in the pillow can help but sounds a bit drastic. Using a piece of foam rubber or a bath sponge, cutting a hole in that, and holding it to the head with a headband, sounds more feasible. Purchasing a silicone splint from a dermatology organisation (not sure where; maybe BAD?) can also be done but is obviously more expensive.
- Protect from cold and wind; wear a warm hat when outdoors. (Luckily not an issue at the time of year that I’m writing this.)
- Ulceration can be treated with petroleum jelly or with antibiotic ointment under a light dressing. In view of antibiotic resistance issues, I prefer the thought of the former.
- Steroid injections, cryotherapy, and collagen injections are all options, although obviously not ones I could try.
- GTN ointment 2% bd can be used in severe cases.
- Surgical excision is an option, but there’s a 10 – 30% recurrence rate.
(DermnetNZ site, plus emedicine)