Auricular Perichondritis in the Cartilage Piercing Era

Objective: To describe the demographics, clinical presentation, treatment, and complications of piercing-induced auricular perichondritis (P-IAP) and non-PIAP. Methods: We reviewed the medical records of consecutive patients diagnosed and treated for P-IAP and P-FAP between 2006 and 2021. The retrieved data included demographics, comorbidities, etiology, location, treatment, complications, and outcome, and they were compared between the two groups. Results: In total, 217 patients fulfilled the inclusion criteria. Of them, 120 (55.3%) comprised the P-IAP group, which was characterized by significantly younger age and fewer comorbidities. The 97 non-PIAP patients tended to present with more systemic and regional signs, while the PIAP group presented with localized signs and significantly more abscess formation and significantly more colonization with Pseudomonas aeruginosa. Time from causative event to symptom onset was significantly shorter in the PIAP group (18.9 ± 38.7 days) compared to the non-PIAP group (29.8 ± 62.9 days, p < 0.021), which also had longer hospitalization. Complications included drainage or debridement, recurrent disease, > 21 days of antibiotic treatment, or requirement of a central line. Abscess formation was the most significant variable associated with complications (OR 35.75 [95% CI: 13.12–97.35, p < 0.001] for the entire cohort, OR 35.59 [95% CI: 10.84–116.84, p < 0.001] for the PIAP group, and OR 47.30 [95% CI: 5.33–419.67, p = 0.001] for the non-PIAP group). No other variables reached a level of significance. Conclusion: PIAP has different demographics, comorbidities, disease course, and microbiology compared to non-PIAP. Abscess formation is an independent factor for complications. Level of Evidence: 3.