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Otitis externa - Management
How should I assess someone with chronic otitis externa?
- Assess presence of precipitating and risk factors, severity of symptoms and inflammation, and patency of tympanic membrane as for acute otitis externa. In addition assess for:
- Severity of itching — usually the most prominent symptom — and signs of scratching.
- Signs of fungal infection on examining the ear canal — whitish cotton-like strands of Candida, small black or white balls of Aspergillus.
- Signs of generalized dermatitis — mild erythema and lichenification (thickening of the skin) in the ear canal, and signs of underlying disease elsewhere (e.g. seborrhoeic dermatitis, psoriasis).
- Evidence of contact allergy or sensitivity — use of ear plugs, hearing aid, earrings, sensitizing medications (topical and systemic).
- Evidence of a source for an id (auto eczematization) reaction — a focus of fungal infection elsewhere in the body (e.g. skin, nails, vagina) can cause a secondary inflammatory process in the external ear canal.
In depth
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