A 13-year-old girl complained of a painful right ear lobe of three days duration. She tried to remove the ear ring and had to abandon the attempt when it started to bleed. Examination showed the right ear lobe was swollen and tender on palpation (Panel). The swelling was firm, with an area of hardness palpable in the centre. There was no pus or discharge from the swelling. On the posterior aspect of right ear lobule, there was a pointed golden needle pin noted (Panel). What is the diagnosis? Answer: refer to page 189

Answer: Embedded ear ring The patient was started on oral antibiotics and an analgesic. Her condition improved with treatment, with reduction of oedema and pain. The hard mass inside the earlobe, which was the gold ear ring, was palpable. The ear ring was removed under local anaesthesia and the wound healed well upon follow-up in the clinic.