[Chronic otitis externa from the dermatologic viewpoint].

Area of Science:

• Otolaryngology
• Dermatology
• Allergology

Context:

• Chronic external otitis presents complex etiological factors.
• Endogenous predispositions include psoriasis, seborrheic eczema, and atopic eczema.
• Exogenous factors involve microbial pathogens and allergens.

Purpose:

• To categorize the diagnostic aspects of chronic external otitis.
• To elucidate the interplay between endogenous and exogenous factors.
• To highlight the role of allergies and predisposing conditions.

Summary:

• Chronic external otitis arises from endogenous factors like eczema and exogenous pathogens.
• Interactions between conditions such as psoriasis and atopic eczema are common.
• Yeast infections and susceptibility to allergies (Type I and IV) are significant.
• Mycotic and bacterial infections correlate with eczema, antibiotic use, and environmental factors.
• Contact allergies, particularly to neomycin, and upper respiratory allergies affecting Eustachian tube function are implicated.
• Diagnostic approaches should include functional assessment of the Eustachian tube and middle ear, alongside allergy testing.
• Therapeutic strategies involve limited-constituent topical preparations, avoidance of allergens, and surgical intervention for ventilation issues.

Impact:

• Informs diagnostic strategies for chronic external otitis.
• Guides therapeutic interventions by considering multifactorial causes.
• Emphasizes the importance of allergy assessment in otitis management.
• Highlights the need for careful selection of topical treatments.
• Suggests surgical options for refractory cases related to middle ear ventilation.