Bill is a 70 year old man with history of sun exposure throughout his life who presents with a painful papule on his right ear.

Causes of painful papule on ear
Chondrodermatitis nodularis helicis chronicum et dolorum (CNH)
BCC
SCC
Gouty tophi
Chillblain
Perichondritis
Polychondritis

Managament of Chondrodermatitis nodularis helicis chronicum et dolorum
Excision
Avoid pressure long term
Sleep on unaffected side
use pillow with hole cut in it
Intralesional steroid injection