Dermatitis of the ear canal is characterized by pruritis, scaling, flaking, and erythema of the skin of the external auditory meatus and ear canal. Dermatitis can be caused by exposure to allergens (contact dermatitis) or can be spontaneous (chronic otitis externa, aural eczematoid dermatitis).
Common contact allergens include nickel-containing earrings and numerous beauty products (eg, hairsprays, lotions, hair dye). Aural eczematoid dermatitis is more common among people with a predisposition toward atopy and with other similar dermatitides (eg, seborrhea, psoriasis).
Both contact dermatitis and aural eczematoid dermatitis cause itching, redness, clear (serous) discharge, desquamation, hyperpigmentation, and, sometimes, fissuring. A secondary bacterial infection can occur (acute otitis externa); this infection tends to cause pain more than itching. Irritants (eg, water, cotton-tipped applicators) can exacerbate both types.
Diagnosis is usually obvious based on physical examination. Contact dermatitis and aural eczematoid dermatitis are distinguished only by the presence of a known contact allergen (eg, use of earrings that contain nickel in contact dermatitis).
Treatment of Chronic Otitis Externa
Avoidance of triggers and/or irritants, including water and cotton-tipped applicators
Usually topical corticosteroids
(See also Otitis Externa and Assessment and Management of Chronic Otitis Externa..)
Contact dermatitis
Aural eczematoid dermatitisacute external otitis
