Perichondritis is an inflammation of the skin of the cartilage (medical term perichondrium). In the majority of cases, inflammation of the cartilage on the auricle develops as part of the disease. Perichondritis also occurs in other areas of the body, such as the larynx or nasal cartilage.
What is perichondritis?
Basically, as part of perichondritis, inflammatory processes develop on the skin of the cartilage. Inflammation of the auricle is the most common. However, perichondritis can also develop in other areas containing cartilage. The nose and larynx are affected.
Perichondritis is usually accompanied by pain originating from the inflamed areas of the cartilage. The skin of the cartilage, the so-called perichondrium, is particularly affected. When perichondritis occurs in the ear, in most cases the external auditory canal is also involved in the disease. The cause is primarily bacterial pathogens that penetrate the skin. See electronicsencyclopedia for Slang HIV.
The point of attack for the bacteria are small injured areas on the skin. It is also possible that the perichondritis occurs in connection with systemic diseases. So-called recurrent perichondritis was first described in 1923 by von Jaksch, a specialist in internal medicine. The disease is now classified as an autoimmune disease.
Causes
In most cases, the causes of perichondritis are bacterial infections. These are usually staphylococci or Pseudomonas. The pathogens often penetrate the human organism through the skin. The affected patients are particularly often infected by the bacteria through skin injuries.
For example, injured areas on the auricle are possible. Some pathogens also penetrate the skin via mosquito bites. In addition, in some cases, perichondritis develops following surgery. People often become infected with perichondritis when piercing their ears.
The risk of contracting the disease increases greatly if the hygienic conditions during the biting are not satisfactory. In addition, the bacterial germs can get into the body through micro-injuries in the auricle. If a so-called othematoma is present and injured, perichondritis is also possible. Sometimes mycobacteria are responsible for the causative infection.
Symptoms, Ailments & Signs
Perichondritis is associated with various symptoms for the affected patients. The diseased areas of cartilage usually swell. In most cases, the corresponding areas redden. In addition, the sick people suffer from more or less severe pain that radiates from the inflammation of the cartilage skin.
If the perichondritis occurs on the auricle, the inflammatory processes are also announced by changes in the relief of the auricle. However, the perichondritis usually does not reach the earlobe. If the perichondritis is not treated adequately, the focus of inflammation spreads to the neighboring areas. In the worst case, the inflammation progresses so far that necrosis develops on the cartilage, which can be of a septic nature, for example.
The majority of the earlobe is not affected by perichondritis because it does not have any cartilage tissue. This also makes the differential diagnosis easier, because in the case of erysipelas, the earlobe is usually affected by the inflammation. The necrosis, which is possible within the framework of perichondritis, in many cases implies changes in the shape of the auricle. Cauliflower ear develops in some people with the disease.
Diagnosis & course of disease
People with typical symptoms and signs of perichondritis are recommended to see a doctor. As part of the anamnesis, the treating doctor clarifies the individual symptoms with the patient and finds out whether injuries have occurred in the area of the affected cartilage . The doctor then inspects the affected areas.
At this point he may already make a suspected diagnosis. In order to unequivocally secure the diagnosis of perichondritis, laboratory analyzes of the relevant tissue are necessary. First, the doctor takes swabs from the inflamed areas and then has them examined. In this way, the responsible bacterial germs can be identified.
Complications
Ear perichondritis is an inflammation of the ear cartilage and surrounding tissues. The earlobe is unaffected because it contains no cartilage. In the beginning, the disease is usually harmless, but it can lead to significant complications if not treated promptly and adequately. In the early stages, blisters form around the infected area and the ear begins to hurt, sometimes the earlobe also turns red.
With insufficient treatment, there is a risk that perichondritis will spread to the entire cartilage of the auricle and auditory canal. A common consequence is tissue death (necrosis). This can be accompanied by a permanent change in the ear cartilage and lead to the so-called cauliflower ear, which is otherwise only observed in martial artists.
In severe cases, it may be necessary to amputate all or part of the ear. If the patient does not want to live with the optical and usually also acoustic impairment, the ear can be replaced with an ear prosthesis. The surgical procedure is associated with general surgical risks.
A particularly high risk of developing severe perichondritis is in diabetics and people with a weakened immune system. Cosmetic interventions on the ear such as piercings or tattoos also entail an increased risk due to the often inadequate hygiene.
When should you go to the doctor?
In the case of redness or painful swelling of the auricle, an appointment with the doctor is recommended. Although perichondritis is not a serious disease, if left untreated it can lead to the development of cartilage necrosis and other complications. Affected people should consult their doctor at the first sign of inflammation. The external redness is a clear warning sign and a reason for a quick visit to the doctor. A bacterial disease should be treated at an early stage so that the pathogens cannot even penetrate to the auricle. Then an oral antibiotic treatment is often possible, through which the pathogens can be destroyed.
Advanced diseases require intravenous antibiotic therapy. If necroses have already developed, surgical intervention is necessary. The perichondritis is treated by the family doctor or the ENT doctor. Advanced diseases are treated as inpatients by a surgeon and other specialists. As part of the aftercare, a few check-ups are usually sufficient to assess the degree of recovery and, if necessary, to adjust the medication.
Treatment & Therapy
Perichondritis can be treated with various means and methods. If the disease is still in a relatively early stage, antibiotics are usually used. These are administered to patients by the oral route. If the inflammation in the context of the perichondritis is already more advanced, the antibiotics are usually injected into the veins. This improves the effectiveness of the medication.
In particular, active ingredients such as ciprofloxacin or levofloxacin have proven themselves. Because these are able to penetrate the cartilage. However, if necrosis has developed on the cartilage, surgical removal of the relevant areas is necessary. This reduces the destruction of the auricle. It is also advisable to use medical rinses on the diseased areas to speed up the healing process.
Outlook & Forecast
In most cases, the further course of perichondritis depends very much on when the disease is recognized and how quickly it is treated. A self-healing of this disease can usually not occur, so that the affected person is always dependent on medical treatment by a doctor. Therefore, a doctor should be contacted as soon as the first symptoms and signs appear. If the disease is not treated, the inflammation usually spreads to other regions of the body and can significantly reduce the quality of life of those affected. Treatment then proves to be relatively difficult.
If the disease is correctly identified and treated by a doctor right from the start, it can usually be well limited and cured with the help of antibiotics. There are no further complications or other complaints. However, even after complete healing, re-infection of the perichondritis is possible. If the disease is not treated, the auricle can be completely and irreversibly destroyed. In most cases, the disease itself does not reduce the life expectancy of those affected.
Prevention
Perichondritis cannot always be prevented. However, the risk of infection is reduced if, for example, scrupulous attention is paid to hygienic standards when piercing.
Aftercare
In most cases, those affected with perichondritis have only a few and only limited options for aftercare. The person concerned should primarily consult a doctor at an early stage so that complications or other symptoms do not arise in the further course. The sooner a doctor is consulted, the better the further course of the disease.
Perichondritis is usually treated by taking various medications, antibiotics being the most common. Regular intake with the correct dosage should always be observed, whereby antibiotics should not be taken together with alcohol. If you have any questions or side effects, you should first consult a doctor with perichondritis in order to avoid complications.
Regular check-ups by a doctor are also very important. If the disease is treated by surgery, the person concerned should take it easy after the procedure and protect the affected region in particular. This can prevent infection and inflammation.
You can do that yourself
In the case of perichondritis, it is usually sufficient to take the prescribed medication and inform the doctor about side effects. The patient does not need to take any further action as the inflammation resolves on its own within a few days.
Further self-help measures only make sense in the event of complications or a late diagnosis. In the case of severe inflammation in the ear area, the medical emergency service must be contacted. If the hearing ability deteriorates massively, a hospital visit is indicated. If the perichondritis was diagnosed late, necrosis may have already formed. These must be surgically removed. After surgery, patients should take it easy and otherwise follow the doctor’s recommendations for wound care. Rinses with agents such as Rivanol have a supporting effect and can be supplemented with natural preparations in consultation with the doctor.
If inflammation occurs again, there may be a serious condition that needs to be diagnosed first. The patient should contact the audiologist or consult an internist. A complaints diary serves as a guide for the doctor, who can use the information about the symptoms and their severity to make a diagnosis.