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Accessory tragus

Deba P Sarma, MD Omaha

One month old boy with papule at the anterior left ear

Congenital anomaly of the first branchial arch. Clinical finding: Small, skin-colored papule or nodule anterior to the tragus.

Microscopic finding: Normal epidermis covers the raised papule containing adipose tissue, normal adnexal structures ( hair, sebaceous glands and eccrine glands) and a central cartilaginous core. Presence of the cartilage is not necessary to make the diagnosis. Differential diagnosis: Acrochordon.