Pigmented lesion on the ear

A 65-year-old farmer came to the office with a pigmented lesion on his left ear; the lesion had been there for about 2 years. He noticed different shades of black developing in the lesion during the previous 3 months.

On physical examination, we observed a 13 mm x 7 mm asymmetrical dark-brown-to-black papule, with pigment fading at its borders, on the lower helix of the patient’s left ear. No ulceration was noted.

As an incidental finding, we noted accumulation of a yellowish waxy material in the left retroauricular area. The right ear was normal on examination, and no mucosal lesions were found. Lymph nodes of the retroauricular, submandibular, occipital, and supraclavicular areas were normal. An excisional biopsy was performed.

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FIGURE 1
Pigmented papule on the ear