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他克莫司和克霉唑油剂治疗外耳道红斑鳞屑性疾病 25 例疗效观察。

Successful treatment of erythematous-squamous disorders of the external auditory canal with tacrolimus and clotrimazole in otic oil: Our experience in 25 patients.

机构信息

Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Granada, Spain.

Department of Psoriasis, Dermatology, Hospital Universitario San Cecilio, Granada, Spain.

出版信息

Dermatol Ther. 2020 Nov;33(6):e14471. doi: 10.1111/dth.14471. Epub 2020 Nov 4.

DOI:10.1111/dth.14471
PMID:33112026
Abstract

The external auditory canal (EAC) comprises a special area where erythematous-scaly diseases are located. Among the main dermatoses that can affect EAC seborrheic dermatitis, psoriasis, irritant or allergic contact dermatitis, chronic external otitis (atrial eczematoid dermatitis) and cutaneous lupus should be considered. In this study, 25 consecutive patients were recruited on our dermatological outpatient clinic, 9 men and 16 women, with a clinical diagnosis of localized erythematous-squamous dermatoses in EAC. The mean age was 48.8 years (16-83). The mean time of evolution of the dermatoses was 11.44 months (2-36). Regarding the diagnosis, 14 patients were diagnosed with seborrheic dermatitis (56%), 9 patients with psoriasis (36%), 1 patient with subacute cutaneous lupus (4%), and 1 patient with allergic contact dermatitis to corticosteroids (4%). The indicated treatment was tacrolimus 0.1% and clotrimazole 1% in otic oil, twice a day, for 1 month. The EAC had to be cleaned initially with saline solution impregnated on a swab from the ears. The IGA score and pruritus showed a high results, with important improvement of almost all patients. The satisfaction of the patients obtained with the TSQM-9 questionnaire was 95.2. Retreatment showed an equal efficacy observed during the first treatment period. The efficacy and the absence of side effects with the treatment make this magistral formula an adequate therapeutic option for these dermatoses.

摘要

外耳道(EAC)包括一个特殊区域,位于该区域的疾病表现为红斑鳞屑性。可影响 EAC 的主要皮肤病有脂溢性皮炎、银屑病、刺激性或过敏性接触性皮炎、慢性外耳炎(外耳道湿疹样皮炎)和皮肤狼疮等。在这项研究中,我们在皮肤科门诊招募了 25 名连续患者,其中 9 名男性和 16 名女性,临床诊断为 EAC 局限性红斑鳞屑性皮肤病。平均年龄为 48.8 岁(16-83 岁)。皮肤病的平均发病时间为 11.44 个月(2-36 个月)。关于诊断,14 名患者被诊断为脂溢性皮炎(56%),9 名患者被诊断为银屑病(36%),1 名患者被诊断为亚急性皮肤狼疮(4%),1 名患者被诊断为对皮质类固醇过敏的接触性皮炎(4%)。推荐的治疗方法是在耳油中每天两次使用 0.1%他克莫司和 1%克霉唑,持续 1 个月。首先,必须用蘸有生理盐水的棉签清洁 EAC。IGA 评分和瘙痒显示出高结果,几乎所有患者的病情都有重要改善。患者对 TSQM-9 问卷的满意度为 95.2%。再次治疗显示出与首次治疗期间观察到的同等疗效。该治疗方法疗效确切,无副作用,是这些皮肤病的合适治疗选择。

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