Attacks of chondritis usually occur in a relapsing and remitting pattern. Inflammatory episodes generally last a few days or weeks and may subside spontaneously or after treatment is initiated; recurrences after weeks or months occur and result subsequently in cartilage destruction. Auricular chondritis is the most frequent (85%), causing pain, redness, and swelling of the cartilaginous portion of the pinna, sparing the noncartilaginous lobe (Fig. 159-1). Biopsy of the auricular cartilage is not usually necessary to make a diagnosis. The histology shows perichondrial inflammation and the loss of the normal cartilaginous basophilia. After several attacks, the pinna may become soft and floppy with a cauliflower appearance (Fig. 159-2); sometimes it is stiff due to calcifications. Nasal chondritis (65%) is less inflammatory, presenting with nasal pain, stuffiness, rhinorrhea, and sometimes epistaxis. The characteristic saddle-nose deformity (Fig. 159-3) may appear secondarily or without previous inflammatory episodes. Respiratory tract chondritis, though uncommon at presentation, occurs in up to 50% of patients, and may be lethal. This results in complaints of hoarseness, nonproductive persistent cough, dyspnea, wheezing. Complications include upper airway collapse, obstructive respiratory insufficiency and secondary infections. Costochondritis (35%) induces parietal pains, which may also compromise respiration.