What Causes Circular Black Patches Behind The Ear?

Posted on Tue, 7 Apr 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 7 Apr 2015 Answered on

Wed, 29 Apr 2015 Last reviewed on

Question : I have circular black patches behind my left ear on the side of the head. They started appearing as a itchy bump and slowly developed into black mole like spot. It started with 1 and theres another one developing now. It is not painfull and stops itching after it grows into a mole like patch. The itching is mild during the outbreak.

Answered by Dr. Hardik Pitroda (40 minutes later)

Brief Answer:
Pictures requested

Detailed Answer:
Hello,
Thank you for posting on HCM.
I can understand your concern regarding the skin lesions but its difficult to point specific diagnosis in absence of clinical examination.
Therefore, I insist you to post good clinical pictures to me so that I can help you in a better way.
You can mail pictures to YYYY@YYYY
with subject titled ' ATTN Dr Hardik Pitroda'.

Thanks
Dr Hardik Pitroda

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hardik Pitroda (23 minutes later)

I have sent the attachments as advised. Please examine and let me know. Many thanks.

Answered by Dr. Hardik Pitroda (11 hours later)

Brief Answer:
History details requested

Detailed Answer:
Thank you for the pictures.
Clinically, these look like lesions of chicken pox in healing phase.
Can you tell in brief some further details for better understanding like:
1. Duration of condition?
2. History of similar complain in past
3. History fever or weakness associated with the lesions in initial few days?
4. Any similar lesions elsewhere on body?
5. History of diabetes or any other medical condition?

Thanks
Dr Hardik Pitroda

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hardik Pitroda (10 hours later)

1. Last 2 months, each one developed one after another.
2. No
3. No
4. No
5. High bp since 4 yrs, taking selomax 50/5 once in morning, bp in control. Not done diabetes test yet.

Answered by Dr. Hardik Pitroda (14 hours later)

Brief Answer:
Oral fluconazole, topical betamethasone and sertaconazole

Detailed Answer:
Since from your history, it doesnot look like chickenpox I would like to treat you for other differential diagnosis of fungal skin infection (tinea) and fixed drug eruption.
If I were your dermatologist, I would suggest you oral fluconazole once a week for 6 weeks and application of cream containing betamethasone and sertaconazole twice a day for 3 weeks.
Antihistaminics can be taken as required for itching.
I am sure this will take care of your issue.
Thanks
Dr Hardik Pitroda

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Hardik Pitroda (30 minutes later)

Please read my statements. I have categorically mentioned that my lesions are mildly itchy during outbreak; so how is this a case of Tinea (ring worm) since that condition is very itchy and grows aggressive with time. I am not convinced at all.

Answered by Dr. Hardik Pitroda (11 hours later)

Brief Answer:
For definitive diagnosis, a consult with dermatologist is must

Detailed Answer:
I can understand your concern, but as I told you its not easy to put forward definitive diagnosis in absence of actual examination, and that's the reason why I have put forward differential diagnosis. Even other conditions like lichen planus, granuloma annulare, Lupus vulgaris would fit the clinical picture here.
I would suggest you discuss these differentials and the treatment I suggested with your dermatologist before taking any treatment.
Even in such diagnostically challenging cases we advocate skin biopsy for definitive diagnosis.
Hope you got my point here.
Thanks

Above answer was peer-reviewed by : Dr. Pradeep Vitta