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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Otoscopic examination and cytology of the equine ear would be beneficial in diseases such as head trauma, headshaking, otitis externa secondary to otitis media, vestibular disease, aural neoplasia and aural pruritus secondary to parasites. In practice, otic examinations of horses are rarely done due to the perceived difficulty in visualizing the equine external ear canal and tympanic membrane, as well as the need for chemical restraint. In this study, the proximal external ear canal was examined in live horses using a handheld otoscope and in cadaver heads using video otoscopy. Visualization of the proximal ear canal of the sedated horse could be done with a handheld otoscope, but more sedation or general anaesthesia and a video otoscope would be required to adequately visualize the tympanic membrane in the live horse. The proximal ear canals of 18 horses were examined cytologically and cultured aerobically. In three horses, both ears were sampled. No cells or organisms were seen on cytological examination of 11/21 ears. Nine of the 21 ears were sterile when cultured. Ten of the 21 ears had mixed growth with low numbers of organisms (Corynebacterium sp. being most common). Two of the 21 ears had heavy growth of a single organism (Corynebacterium sp. and Staphylococcus intermedius, respectively). Equine cadaver heads were examined in cross-section by computed tomography (CT) imaging and histopathology in order to further understand the anatomy of the equine external ear canal. Equine practitioners should be aware that otic examination is possible and may provide important diagnostic information.
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PMID:Otoscopic, cytological, and microbiological examination of the equine external ear canal. 1667 32

We report two cases of carcinoma in situ in the external auditory canal (EAC), presenting with symptoms such as pain, long-term itching of the ear, easy contact bleeding, canal otorrhea and hearing loss. Otoscopic examination revealed granulation tissue and a greyish-black tumour with irregular surface. The first patient had previously been diagnosed with otitis externa with persistent ear itching for the past three years. The second patient had received tympanoplasty for treatment of chronic otitis media on the right ear ten years ago. The first case was treated with wide excision, whereas the second patient received resection of the skin of the EAC together with its adjacent soft tissue, followed by skin grafting. No tumour recurrence was noted in the fourth and third post-operative year for the first and second patient respectively. We suggest that EAC carcinoma can be detected early and treated.
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PMID:Squamous cell carcinoma in situ of the external auditory canal. 1671 55

A long-standing diffuse chronic otitis externa can lead to itching. Resultant scratching may then lead to irreversible skin changes with canal stenosis by scar tissue. The poor ventilation and increased humidity gives rise to bacterial and fungal growths leading to breakdown of the skin defences and worsening itching. This vicious itching-scratch cycle or downward spiral often fails to respond to medical treatment. For these cases a simple conchal flap meatoplasty may improve ventilation of the external auditory canal and may lead to a self cleaning ear. We reviewed 84 patients who had undergone conchal flap meatoplasty in Calderdale and Huddersfield NHS Trust Hospitals from April 1993 to June 2002. A long-term follow up of conchal flap meatoplasty in chronic otitis externa showed no records of complications or further otitis in 93.2 per cent of cases. Thus surgical intervention plays an important role in the treatment of otitis externa not responding to treatment.
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PMID:A long term follow up of conchal flap meatoplasty in chronic otitis externa. 1705 29

Otitis externa can take an acute or a chronic form, with the acute form affecting four in 1,000 persons annually and the chronic form affecting 3 to 5 percent of the population. Acute disease commonly results from bacterial (90 percent of cases) or fungal (10 percent of cases) overgrowth in an ear canal subjected to excess moisture or to local trauma. Chronic disease often is part of a more generalized dermatologic or allergic problem. Symptoms of early acute and most chronic disease include pruritus and local discomfort. If left untreated, acute disease can be followed by canal edema, discharge, and pain, and eventually by extra-canal manifestations. Topical application of an acidifying solution is usually adequate in treating early disease. An antimicrobial-containing ototopical is the preferred treatment for later-stage acute disease, and oral antibiotic therapy is reserved for advanced disease or those who are immunocompromised. Preventive measures reduce recurrences and typically involve minimizing ear canal moisture, trauma, or exposure to materials that incite local irritation or contact dermatitis.
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PMID:Otitis externa: Review and clinical update. 1711 89

Recurrent exacerbation in chronic recalcitrant external otitis (EO) often warrants multidisciplinary treatment and collaboration with a dermatologist. The aim of this pilot study was to ascertain the efficacy of topical tacrolimus ointment application in chronic, non-infectious and therapy-resistant EO. In a prospective clinical study, the efficacy of tacrolimus ointment 0.1% was examined in 53 patients with therapy-refractory chronic EO of confirmed non-infectious etiology. Clinical examination took place prior to treatment (V1), at the end (V2) and during follow-up investigations (V3) of 28 patients over 10-22 months. Patients were evaluated for the symptoms otalgia, edema, otorrhea, erythema, pruritus and desquamation on a 6-point scale. The short-term results after topical application of tacrolimus (V2) showed a clear improvement in 85% of the patients (N = 45) and significant drop in severity scores for all clinical parameters (p < 0.001). The long-term follow-up studies (V3) revealed that a one-time treatment cycle led to complete remission in 46% of patients (N = 28). The remaining 54% had recurrent EO events, however, with significantly longer symptom-free intervals. Within the observation period, no relevant local or systemic side effects were observed, except for occasional skin burning, stinging, or itching. This interdisciplinary study between dermatologists and ENT specialists clearly demonstrates that the topical application of 0.1% tacrolimus ointment is an effective and well-tolerated new option in the treatment of chronic recalcitrant EO. Furthermore, it shows that dermatologists, with their experience in topical immunomodulatory therapy, can make valuable contributions to the treatment of inflammatory disorders in other medical fields.
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PMID:Topical tacrolimus treatment for chronic dermatitis of the ear. 1767 84

The objective of the study was to determine if the addition of topical antibiotic increases the efficacy of topical steroid in controlling otitis externa. A double-blind randomised controlled trial was performed from February 2003 to April 2005 in an otolaryngology emergency clinic (acute urban teaching hospital) in the United Kingdom. Patients were followed up for 2 weeks. Forty-five adults with otitis externa based on the presence of oedema, discharge or debris in the outer ear canal were recruited. The patients were randomised to one of the two treatment groups, namely using betamethasone sodium phosphate 0.1% (Vista-Methasone) or betamethasone sodium phosphate 0.1% with neomycin sulphate 0.5% (Vista-Methasone N), and were instructed to use the trial medication at three drops three times a day for 2 weeks. Subjects' visual analogue symptom scores (blockage, pain, discharge, and itching) for otitis externa pre-treatment (day 0) and post-treatment (day 15), percentage changes in visual analogue symptom scores as a result of treatment, proportion of patients whose symptom scores failed to improve or deteriorated on treatment were analysed. The two experimental arms demonstrated statistically similar presenting symptom scores at recruitment (mean symptom scores of 19.2 for betamethasone group and 28.7 for betamethasone-neomycin group). The mean symptom score change in response to treatment was 82.8 and 47.8% in the betamethasone-neomycin and betamethasone-alone groups, respectively. There was no statistically significant difference between the groups in median percentage symptom score change in response to treatment. All patients in the betamethasone-neomycin group showed symptom improvement but in the betamethasone alone group, five patients got worse (Fishers exact, P = 0.05). Topical antibiotic-steroid combination therapy is superior to steroid-alone treatment for symptomatic control of otitis externa.
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PMID:A double-blind randomised clinical trial of the treatment of otitis externa using topical steroid alone versus topical steroid-antibiotic therapy. 1856 Aug 73

Malassezia-positive smears can be recognized from otitis externa, however, there are few references in the literature to the relation between Malassezia and otitis externa. Therefore, the bacterial and clinical characteristics of 72 cases (63 patients) with otitis externa were investigated at the Department of Otorhinolaryngology, Takinomiya General Hospital to analyze this. Thirty-seven cases were bacterial otitis externa, 20 cases were fungal otitis externa, and 15 cases were etiological agents unknown in this study. The causative organisms in fungal otitis externa were the genera Aspergillus (10 cases), Malassezia (5) and Candida (5), respectively. We suspected that 5 cases were caused by Malassezia because Malassezia cell counts were greater than 10 per field (x 400), and a large number of Malassezia were isolated from all cases. In these cases, many squamous epithelial cells were observed by direct examination, and cells from the middle or basal layer of the ear canal were also recognized in three cases. Therefore, accelerated turnover of epidermal cells of the ear canal was suggested. The main symptoms were itching and fullness in the ear, with observations of redness and erosion in objective deterioration, and we felt that these conditions were similar to seborrheic dermatitis (SD). In addition, these five cases were confirmed as fungus-related otitis externa by their improvement with antifungal agents.
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PMID:[A study of otitis externa associated with Malassezia]. 1943 Jan 86

Entire books have been written on the subject of canine ear disease. Rather than attempt to present all the available information here, I am providing an overview of how I diagnose and manage ear disease in dogs. It is critical to appreciate that ear disease is only a clinical problem (no more specific than pruritus) and that steps must be taken to prevent otitis externa from progressing to proliferative otitis. BOX 1 summarizes step-by-step approaches to specific clinical scenarios.
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PMID:A practical approach to diagnosing and managing ear disease in dogs. 1951 12

A 12-year old, castrated male domestic shorthair cat presented with a 2-year history of poor hair coat, seborrhea, generalized pruritus and otitis externa. Low circulating concentrations of total serum thyroxine (TT(4)) and free thyroxine (fT(4)) and an elevated thyroid stimulating hormone concentration supported a diagnosis of primary hypothyroidism. Thyroid scintigraphy did not show uptake of radioactive technetium in the thyroid area. Treatment with levothyroxine resulted in clinical improvement. Recurrence of dermatitis 8 months after onset of treatment resulted in euthanasia of the cat. On post-mortem examination, thyroid tissue was not identified on gross or histological examination. Pituitary immunohistochemistry identified hyperplasia of chromophobe cells.
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PMID:Use of thyroid scintigraphy and pituitary immunohistochemistry in the diagnosis of spontaneous hypothyroidism in a mature cat. 1969 15

Inflammations of the external auditory canal number among the most frequently occurring ear-nose-throat diseases. For local treatment, substances from various groups of active ingredients are used as combinations and as single-agent drugs, e.g. antibiotics, glucocorticoids or analgesics [1]. In the case of acute otitis externa, treatment measures focus on the reduction of pain and swelling. The study described here investigates the efficacy and safety of glycerol lidocaine eardrops for the treatment of acute abacterial otitis externa (CAS No. for glycerol: 56-81-5, lidocaine-HCl: 73-78-9). In this double-blind, three-arm study, 105 patients diagnosed with acute abacterial otitis externa were included and randomized to receive either glycerol eardrops, glycerol eardrops with 0.5% lidocaine, or glycerol eardrops with 2% lidocaine for seven days. The primary outcome parameter was the change of the five typical clinical symptoms, earache, itching, otorrhea, hearing impairment, and "clogged ear" at Visit 2 (Day 7) based on the initial examination on Day 0. Both therapy groups treated with a combination of glycerol and lidocaine exhibited definite improvement in overall symptoms after seven days. This improvement differed from the mild reduction of symptoms under treatment with glycerol eardrops alone. Overall improvement of symptoms, expressed by the area under the curve of the baseline-adjusted symptom sum score, yielded a mean value of 10.95 (standard deviation 27.4) for the morning survey of the groups receiving eardrops containing only glycerol; in comparison, for eardrops containing glycerol and 2% lidocaine it was 15.71 (+/- 23.6) and for glycerol with 0.5% lidocaine, 23.16 (+/- 19.4). No severe adverse events occurred. Five adverse events were documented during the clinical investigation, none of which was considered by the investigators to be related to the study medication. Local therapy with glycerol lidocaine eardrops is a safe, and cost-effective treatment for the widely spread clinical picture of acute abacterial otitis externa. The advantage regarding efficacy of this combination compared with glycerol eardrops must be demonstrated in an adequately powered clinical trial.
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PMID:Glycerol lidocaine eardrops for the treatment of acute abacterial otitis externa. 2071 32


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