Preauricular tags or pits
Page most recently updated 7 September 2026
This page focuses on preauricular tags or pits as a morphologic feature of conditions that may also be associated with psychiatric manifestations, such as psychosis, mania, autism spectrum disorder, ADHD, OCD, and self-injurious behaviours. The page begins with a clinical definition of preauricular tags or pits based on the standardized Elements of Morphology terminology, together with visual examples from the same source. This is followed by a list of conditions in which preauricular tags or pits have been described in association with psychiatric manifestations.
Of note, to optimize clinical utility, the list does not include conditions associated with intellectual disability in the absence of other psychiatric features.
Each condition listed below is linked to a dedicated page within this resource. These pages describe the psychiatric manifestations associated with each condition, as well as other morphologic and broader clinical features, allowing the differential diagnosis to be considered from multiple perspectives.
Preauricular tag
Image credit: National Human Genome Research Institute (NHGRI), Elements of Morphology; cropped from original figure.
Preauricular pit
Image credit: National Human Genome Research Institute (NHGRI), Elements of Morphology.
Definition
Objective:
Preauricular tag: Small non-cartilaginous protrusion anterior to the insertion of the ear.
Preauricular pit: Small indentation anterior to the insertion of the ear.
Note: The location of these tags and pits is the plane of fusion of the first branchial cleft. At times it can be a challenge to distinguish tags from other pedunculated lesions in this area; specifically duplications of ear components, Pretragal ectopias, or a striatal muscle hamartoma. Preauricular tags usually lack hair, are limited to the plane of fusion, and do not contain striated muscle.
Conditions with potential psychiatric associations
Selected references and further reading — Morphologic lens
Allanson JE, Biesecker LG, Carey JC, Hennekam RCM. Elements of morphology: introduction. Am J Med Genet A. 2009;149A(1):2-5.
Hennekam RCM, Biesecker LG, Allanson JE, Hall JG, Opitz JM, Temple IK, Carey JC; Elements of Morphology Consortium. Elements of morphology: general terms for congenital anomalies. Am J Med Genet A. 2013;161A(11):2726-2733.
Jones KL, Jones MC, del Campo M. Smith's recognizable patterns of human malformation. 8th ed. Philadelphia: Elsevier; 2021.
Reardon W. The bedside dysmorphologist: a guide to identifying and assessing congenital malformations. 2nd ed. Oxford: Oxford University Press; 2016.