Therapeutic effect of Castellani's paint in patients with an itchy ear canal

Comparison of Therapeutic Effects of Topical Calcineurin Inhibitor and Moisturizing Cream on Pruritic External Auditory Canal

Although pruritic external auditory canal (PEAC) is a relatively common symptom, particularly in the geriatric population, its pathophysiology and appropriate treatment remain to be elucidated. We compared the therapeutic efficacy of pimecrolimus, a topical calcineurin inhibitor (CI), and a moisturizing cream (MC) in patients with PEAC. Thirty-nine patients (73 ears) were prospectively enrolled and treated topically twice daily with the CI (n = 20, 39 ears) or the MC (n = 19, 34 ears) for two weeks. The change in itching sensation was evaluated subjectively using a self-questionnaire at immediately, one month, and two months after self-application, and objectively by changes in erythema grading. Although topical treatment with the CI resulted in a more rapid improvement than treatment with the MC in patients with PEAC, the final outcomes did not differ between the groups. Furthermore, similar improvements in erythema scores were noted. The results of this study suggest that the MC, which rejuvenates the normal physiological status of the ear canal skin, may greatly benefit those elderly patients more susceptible to PEAC, without any concerns about adverse events and underlying comorbidities. Expanding upon the understanding of the role of moisturizers in the treatment of pruritic ears merits attention, as this knowledge provides a good example of the clinical guidelines for the management of PEAC.

[Modern aspects of inflammatory external ear diseases treatment]

The article deals with the problem of inflammatory diseases of the external ear. A review of pruritic dermatoses of the external auditory canal was carried out. It has been shown that in chronic dermatoses, the contamination of the skin with bacterial and fungal pathogens significantly increases, which leads to a high risk of developing secondary infectious pathological processes. Treatment of dermatological inflammatory ear diseases includes careful daily hygiene of the external auditory canal and pharmacotherapy, a key aspect of which is the use of topical etiotropic, anti-inflammatory, and symptomatic drugs. The advantage of the combined drug candiderm is described, which, thanks to the unique combination of beclomethasone, gentamicin and clotrimazole in the composition, effectively relieves the symptoms of external ear dermatoses.

Why do infants pull their ears?

OBJECTIVE

In this study, we aimed to evaluate the diagnoses of the infants who were admitted to our outpatient clinic with the complaint of pulling on the ear and to identify the related factors which may contribute to the diagnosis.

METHODS

This prospective study included a total of 102 infants who were admitted to our hospital with the complaint of tugging and pulling on, touching, and rubbing the ears on the shoulder or pillow and shaking the head between July 2016 and July 2017. The complaints were evaluated throughout the day, and the application seasons, the person referred the patient to the ear, nose, and throat (ENT) specialist, the child development specialist and child psychiatrist, allergy and atopy histories, and the relationship between the results and diagnoses were evaluated.

RESULTS

46.1% of the patients had normal examination findings, while the second most common finding was cerumen in 37.2%, and the third one was otitis media with effusion (OME) in 16.7%. In infants who were directly referred by the family, normal and serological diagnosis were found to be statistically significantly higher than that of OME diagnosis, whereas in the infants referred by the family physicians and pediatrist, the OME was found to be statistically significantly higher than normal and cerumen levels. The presence of additional complaints in the OME group was found to be higher than normal and cerumen group. In those with complaints during the day, the most common finding was OME, while it was cerumen in those with complaints a few times in a day and normal examination finding in those tugging on their ears only, when they were falling asleep, indicating statistical significance. Of 47 infants with normal physical examination findings, 37 were assessed by the child psychiatrist, and depression was found in six of one of the parents during the family interviews.

CONCLUSION

In this study, the majority of the infants referred to the ENT outpatient clinic had normal examination findings, while the rate of OME diagnosis was high. Considering the negative consequences of EOM in infants, the diagnosis of the EOM becomes extremely important. If there are no otologic pathologies in the majority of infants who were admitted with ear pulling and tugging, the possibility of different factors in etiology gives rise to thought. Therefore, further studies are required to prove this condition.