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Question: Can you identify this condition?

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Dermacase

Vol 58: JulY • JuIllET 2012

|

Canadian Family Physician•Le Médecin de famille canadien

767

Answer on page 772

Can you identify this condition?

Brent M. McGrath

MD MSc PhD

Brian D. Ashton

MD CCFP

A

9-month-old white boy is brought in by his parents because of concern regarding a small lesion just anterior to the tragus of his right ear. The lesion has been present and unchanged since birth.

Examination reveals a single, 2-mm wide by 3- to 4-mm long, soft, pedunculated, skin-coloured papule with vellus hair growth located in the right preauricular region. Dermatologic examination reveals no other similar lesions. However, a small, shallow dimpling of the skin on the superior aspect of the right gluteal area is noted. The boy was born at 37 weeks’ gestation, following an uncomplicated preg- nancy and delivery. His Apgar scores were 7 at 1 minute and 8 at 5 minutes. He had a birth weight of 3432 g, a length of 52 cm, and a head circumference of 34 cm. The neonatal period was complicated by a 5-day admission to the neonatal intensive care unit for transient tachypnea. He has been doing well since discharge home, plotting on the 50th percentile for weight and developing normally. There are otherwise no parental concerns.

The most likely diagnosis is

1. Auricular fistula

2. Branchial cyst

3. Accessory tragus

4. Epidermoid cyst

5. Preauricular skin tag

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Vol 56: july • juillet 2010 Canadian Family Physician • Le Médecin de famille canadien