Pre-auricular pits

LAST UPDATED: Oct 24, 2023

Acknowledgements: Dr Perdy Kamali (GPwER in Dermatology & Skin Lesion management) who developed this chapter.

Introduction

Pre-auricular pits are benign small dents seen in front of the upper ear marking the opening of a sinus tract.

This chapter is set out as follows:

Aetiology
History
Clinical findings
Images
Investigations
Management

Aetiology

They are a benign congenital malformation which causes a sinus tract to develop in the pre-auricular skin. These are distinct from pre-auricular cysts which do not communicate with the skin.

History

Present from birth
Affect approximately 1% of the general population
May be bilateral in up to 25% cases
Generally asymptomatic, but can lead to infections and cyst formation

Clinical findings

Distribution

Found anterior to the helix and superior to the tragus

Morphology

Small single indentation or opening seen in the skin
Lined with squamous epithelium

Clinical Images

Please refer to notes on image rights at bottom of the page with regards to individual image ownership.

Investigations

None required if occurring in isolation
Can be associated with unilateral hearing loss, ensure routine newborn hearing screening has been undertaken
Other rare associations include branchio-oto-renal syndrome (comprising pre-auricular pits, branchial fistula, hearing loss and renal abnormalities)

Management

Reassurance. Although permanent, most do not require treatment
Complete surgical excision of the pre-auricular sinus is only indicated in the context of recurrent infection

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Image Rights - The PCDS would like to thank Dermatoweb, DermQuest (Galderma), and others who have contributed images. All named individuals and organisations maintain copyright for the relevant images.