Abstract
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.
Highlights
Pruritic external auditory canal (PEAC), otherwise known as “itchy ear syndrome”, is an isolated itching sensation in the ear canal in the absence of any underlying local or systemic pathology [1]
The pathophysiology of PEAC has not been clearly elucidated, previous research has suggested that changes in the physiology of the EAC skin contribute to the development of isolated and prolonged itching sensations [4]
The patients were randomly classified into two groups and treated topically twice daily with a topical calcineurin inhibitor, a nonsteroidal anti-inflammatory agent
Summary
Pruritic external auditory canal (PEAC), otherwise known as “itchy ear syndrome”, is an isolated itching sensation in the ear canal in the absence of any underlying local or systemic pathology [1]. A relatively acidic pH and hydrophobic milieu in the external auditory canal (EAC), which elicits bacteriostatic properties, is required for the maintenance of a healthy EAC environment [3]. The pathophysiology of PEAC has not been clearly elucidated, previous research has suggested that changes in the physiology of the EAC skin contribute to the development of isolated and prolonged itching sensations [4]. Previous studies that utilized steroid drops showed positive treatment outcomes in terms of symptom relief [6,7]. There is a need to introduce novel, safe, and effective treatments for patients with PEAC
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