Bilateral Pruritic Auricular Papules and Plaques.

A 59-year-old woman presented with several years of persistent and worsening bilateral pruritic auricular lesions. The rash was limited to the ears, and the patient did not have a history of a similar rash on other areas of her body. She reported rubbing and scratching her ears often. A trial of ketoconazole shampoo and triamcinolone cream was ineffective. Examination revealed cobblestoned, slightly keratotic, brown papules and plaques on the concave surfaces of both ears (Figures 1 and 2). The physical examination was otherwise unremarkable. A punch biopsy of the plaque was performed. Question