Main Articles

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

B Acar^a1 c1, H Karabulut^a1, Y Sahin^a1, M A Babademez^a1, A S Karadag^a2 and R M Karasen^a1

^a1 Department of Otorhinolaryngology, Kecioren Training and Research Hospital, Ankara, Turkey

^a2 Department of Dermatology, Kecioren Training and Research Hospital, Ankara, Turkey

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.

(Accepted June 16 2009)

(Online publication November 19 2009)

Key words

• Otitis Externa;
• Pruritis;
• Pimecrolimus;
• Hydrocortisone

Correspondence:

^c1 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

Footnotes

Dr B Acar takes responsibility for the integrity of the content of the paper.

Competing interests: None declared