Hostname: page-component-848d4c4894-pjpqr Total loading time: 0 Render date: 2024-06-23T05:22:20.752Z Has data issue: false hasContentIssue false
  • English
  • Français

New treatment strategy and assessment questionnaire for external auditory canal pruritis: topical pimecrolimus therapy and Modified Itch Severity Scale

Published online by Cambridge University Press:  19 November 2009

B Acar ,
H Karabulut ,
Y Sahin ,
M A Babademez ,
A S Karadag  and
R M Karasen
B Acar*
Affiliation:
Department of Otorhinolaryngology, Kecioren Training and Research Hospital, Ankara, Turkey
H Karabulut
Affiliation:
Department of Otorhinolaryngology, Kecioren Training and Research Hospital, Ankara, Turkey
Y Sahin
Affiliation:
Department of Otorhinolaryngology, Kecioren Training and Research Hospital, Ankara, Turkey
M A Babademez
Affiliation:
Department of Otorhinolaryngology, Kecioren Training and Research Hospital, Ankara, Turkey
A S Karadag
Affiliation:
Department of Dermatology, Kecioren Training and Research Hospital, Ankara, Turkey
R M Karasen
Affiliation:
Department of Otorhinolaryngology, Kecioren Training and Research Hospital, Ankara, Turkey
*
Address for correspondence: Dr Baran Acar, Department of Otorhinolaryngology, Kecioren Training and Research Hospital, Pınarbaşı mahallesi sanatoryum caddesi Ardahan sok no 1, Keçiören, 06310, Ankara, Turkey. Fax: +90 312 356 90 22 E-mail: drbaranacar@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We aimed to compare the efficacy of topical pimecrolimus versus hydrocortisone in treating external auditory canal pruritis, using the Modified Itch Severity Scale as an assessment tool.

Methods:

We included in the study 40 patients with isolated itching of the external auditory canal who had not received any benefit from previous topical and systemic treatments. Topical 1 per cent pimecrolimus or topical hydrocortisone was applied to each patient's external auditory canal for three months. A Modified Itch Severity Scale was developed and used to assess treatment response.

Results:

Compared with itching scores on initial assessment, the scores of patients receiving topical pimecrolimus had decreased by 52.3 per cent by the third week of treatment and by 77.6 per cent by the third month, whereas the scores of patients receiving topical hydrocortisone had decreased by 34.4 per cent by the third week and by 64.2 per cent by the third month.

Conclusions:

Topical pimecrolimus appears to be as effective as topical hydrocortisone in relieving external auditory canal pruritis. We used a novel scoring system, the Modified Itch Severity Scale, to evaluate external auditory canal pruritus; this is the first self-reporting questionnaire for the quantification of external auditory canal pruritus severity. Further studies are needed to validate this scoring system.

Keywords

Otitis ExternaPruritisPimecrolimusHydrocortisone
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 2 , February 2010 , pp. 147 - 151
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1King, WP. Allergic disorders in the otolaryngologic practice. Otolaryngol Clin North Am 1985;18:677–90CrossRefGoogle ScholarPubMed
2Kolbe, L, Kligman, AM, Schreiner, V, Stoudemayer, T. Corticosteroid-induced atrophy and barrier impairment measured by non-invasive methods in human skin. Skin Res Technol 2001;7:73–7CrossRefGoogle ScholarPubMed
3Meurer, M, Fartasch, M, Albrecht, G, Vogt, T, Worm, M, Ruzicka, T et al. Long-term efficacy and safety of pimecrolimus cream 1% in adults with moderate atopic dermatitis. Dermatology 2004;208:365–72CrossRefGoogle ScholarPubMed
4Alomar, A, Berth-Jones, J, Bos, JD, Giannetti, A, Reitamo, T, Ruzicka, T et al. The role of topical calcineurin inhibitors in atopic dermatitis. Br J Dermatol 2004;151:3–27CrossRefGoogle ScholarPubMed
5Simpson, D, Noble, S. Tacrolimus ointment: a review of its use in atopic dermatitis and its clinical potential in other inflammatory skin conditions. Drugs 2005;65:827–58CrossRefGoogle ScholarPubMed
6Amrol, D, Keitel, D, Hagaman, D, Murray, J. Topical pimecrolimus in the treatment of human allergic contact dermatitis. Ann Allergy Asthma Immunol 2003;91:563–6CrossRefGoogle ScholarPubMed
7Acar, B, Sahin, Y. In reference to topical pimecrolimus 1% for the treatment of pruritic external auditory canals. Laryngoscope 2007;117:1319CrossRefGoogle Scholar
8Majeski, CJ, Johnson, JA, Davison, SN, Lauzon, GJ. Itch Severity Scale: a self-report instrument for the measurement of pruritus severity. Br J Dermatol 2007;156:667–73CrossRefGoogle Scholar
9Derebery, J, Berliner, KI. Foot and ear disease – the dermatophytid reaction in otology. Laryngoscope 1996;106:181–6CrossRefGoogle ScholarPubMed
10Stroman, DW, Roland, PS, Dohar, J, Burt, W. Microbiology of normal external auditory canal. Laryngoscope 2001;111:2054–9CrossRefGoogle ScholarPubMed
11Karakuş, MF, Arda, HN, Ikincioǧullari, A, Gedikli, Y, Coşkun, S, Balaban, N, Akdoǧan, O. Microbiology of the external auditory canal in patients with asteatosis and itching [in Turkish]. Kulak Burun Bogaz Ihtis Derg 2003;11:33–8Google ScholarPubMed
12Caffier, PP, Harth, W, Mayelzadeh, B, Haupt, H, Sedlmaier, B. Tacrolimus: a new option in therapy-resistant chronic external otitis. Laryngoscope 2007;117:1046–52CrossRefGoogle ScholarPubMed
13Osguthorpe, JD, Nielsen, DR. Otitis externa: review and clinical update. Am Fam Physician 2006;74:1510–16Google ScholarPubMed
14Li, LY, Cruz, PD Jr.Allergic contact dermatitis: pathophysiology applied to future therapy. Dermatol Ther 2004;17:219–23CrossRefGoogle ScholarPubMed
15Van Hasselt, P, Gudde, H. Randomized controlled trial on the treatment of otitis externa with one per cent silver nitrate gel. J Laryngol Otol 2004;118:93–6CrossRefGoogle ScholarPubMed
16Hughes, RG, Courteney-Harris, RG, Wilson, PS. Longer term follow up for treatment of chronic otitis externa by KTP/532 laser. J Laryngol Otol 2001;115:862Google ScholarPubMed
17Mabry, RL. Treatment of itching ears with fluocinolone acetonide. Eye Ear Nose Throat Mon 1974;53:333–4Google ScholarPubMed
18Djalilian, HR, Memar, O. Topical pimecrolimus 1% for the treatment of pruritic external auditory canals. Laryngoscope 2006;116:1809–12CrossRefGoogle ScholarPubMed
19Yosipovitch, G, Zucker, I, Boner, G, Gafter, U, Shapira, Y, David, M. A questionnaire for the assessment of pruritus: validation in uremic patients. Acta Derm Venereol 2001;81:108–11CrossRefGoogle ScholarPubMed