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Relapsing Polychondritis — SCE Dermatology MCQ

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ModerateConnective Tissue & VasculitisRelapsing PolychondritisSCE Dermatology

A 30-year-old woman has relapsing polychondritis. She presents with painful erythematous swelling of both ear pinnae sparing the non-cartilaginous earlobes. She also has nasal chondritis. What is pathognomonic about the ear involvement?

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Correct answer: E — Auricular chondritis characteristically spares the earlobe (which has no cartilage) — this pattern is virtually diagnostic

Relapsing polychondritis is characterised by recurrent episodes of cartilage inflammation. Auricular chondritis (affecting the cartilaginous pinna while SPARING the non-cartilaginous earlobe) is the most common presentation and is virtually pathognomonic. Other features include nasal chondritis (saddle nose deformity), laryngotracheal chondritis (airway compromise — most dangerous), ocular inflammation, and audiovestibular involvement. Biopsy shows loss of basophilic staining of cartilage with perichondrial inflammation. Treatment is systemic (Dapsone, Prednisolone, Methotrexate, or biologics for severe cases). Airway involvement requires urgent ENT assessment.

Reference: BAD 2019; Rheumatology Review