It is always important to examine the ears carefully when
carrying out a skin check. This small
pigmented lesion was a regressed invasive melanoma 0.2 mm thick. The patient
was entirely unaware of it’s existence. Men are particularly susceptible to
solar damage on the ear because of their short hair. It is exacerbated by only
wearing a baseball cap rather than a brimmed hat. It is a good idea to run your
finger over the surface of the pinna. This will pick up small solar keratoses
better than just visually examining the ear.
Always examine the junction of the ear with the skull posteriorly. Basal
cell carcinoma can arise here and go deep into this embryonic fusion area.
Another area to look at carefully is in the conchae around the external
auditory meatus. Again men are more likely than women to develop BCCs in this
area and if it is an infiltrating BCC and it starts to grow into the external
meatus and down the auditory canal, then the patient is in real trouble. Note also that squamous cell carcinomas of
the ear are more likely to metastasise than many other areas of the body and so
should be excised widely and early.
