Relapsing polychondritis

A 57-year-old man presented with a 2-year history of (1) recurrent swelling of the ears that spared his earlobes and (2) migratory arthralgias. A biopsy specimen of the ear showed a perichondrial infiltrate of lymphocytes, plasma cells, and a few neutrophils. There were acellular foci of underlying cartilage. Relapsing polychondritis is characterized by recurrent inflammation and eventual destruction of cartilaginous tissues, primarily affecting the ears, nose, respiratory tract, and eyes. The condition, which is associated with autoimmunity against type II collagen, has a chronic, relapsing-and-remitting course that can be life-threatening. Treatments include a variety of anti-inflammatory and anti-neutrophilic agents, and the prognosis is variable and depends on which organ systems are involved and the response to therapy.