MODEL RELEASED. Skin lesion on a patient's outer ear (pinna). This benign (non-cancerous) painful lesion is due to the disease chondrodermatitis nodularis helicis (CNH). CNH is common in men over 50, the lesions are always found on the border or elevations of the ears. It is thought to be caused by reduced blood flow to the cartilage of the ear. The reduced blood flow is often caused by the pressure of sleeping on the ear, although there are a number of other factors, including cold and trauma, that can cause it. Treatment is with cortisone ointments or injections. Surgery may be used to remove the lesion, but there is a high rate of recurrence.