Chondrodermatitis nodularis chronica helicis and photodynamic therapy: a new therapeutic option?

Chondrodermatitis nodularis chronica helicis (CNCH) is a fairly frequent disorder of unknown etiology. Although the elective therapy is surgery, local application of topical steroids, antibiotic ointments, intralesional injection of collagen, cryotherapy, curettage followed by diathermy, and CO2 laser treatment have also been proposed. The aim of the study was to test the utility of photodynamic therapy (PDT) for CNCH. Two patients with painful CNCH underwent PDT with a 635 nm light source for 20 minutes (70 J/cm2) after application of cream containing 20% 5-aminolevulinic acid (5-ALA) and occlusion for 3 hours. The lesions decreased considerably in size and pain ceased within a few weeks. The results suggest that this method can be useful for treating CNCH, especially in patients with contraindications for surgery.