Lee Sang-Yeon, Cho Soyun, Kim Minju, Lee Dong-Han, Kim Young Ho
Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea.
Medical Research Center, Sensory Organ Research Institute, Seoul National University, Seoul 03080, Korea.
J Clin Med. 2021 Sep 22;10(19):4313. doi: 10.3390/jcm10194313.
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 ( = 20, 39 ears) or the MC ( = 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.
尽管外耳道瘙痒（PEAC）是一种相对常见的症状，尤其是在老年人群中，但其病理生理学和适当的治疗方法仍有待阐明。我们比较了局部用钙调神经磷酸酶抑制剂（CI）吡美莫司和保湿霜（MC）对PEAC患者的治疗效果。前瞻性纳入39例患者（73只耳），分别用CI（n = 20，39只耳）或MC（n = 19，34只耳）每日局部治疗两次，持续两周。在自行用药后即刻、1个月和2个月时，通过自我问卷主观评估瘙痒感的变化，并通过红斑分级的变化进行客观评估。尽管在PEAC患者中，局部用CI治疗比用MC治疗改善更快，但两组的最终结果并无差异。此外，红斑评分的改善情况相似。本研究结果表明，能恢复耳道皮肤正常生理状态的MC，可能使那些更容易发生PEAC的老年患者受益匪浅，且无需担心不良事件和潜在的合并症。深入了解保湿剂在治疗耳部瘙痒中的作用值得关注，因为这一知识为PEAC的管理提供了临床指南的一个很好范例。
