New treatment strategy and assessment questionnaire for external auditory canal pruritus: topical pimecrolimus therapy and Modified Itch Severity Scale.

Author(s): Acar B, Karabulut H, Sahin Y, Babademez MA, Karadag AS, Karasen RM

Affiliation(s): Department of Otorhinolaryngology, Kecioren Training and Research Hospital, Ankara, Turkey. drbaranacar@gmail.com

Publication date & source: 2010-02, J Laryngol Otol., 124(2):147-51. Epub 2009 Nov 19.

Publication type: Randomized Controlled Trial

OBJECTIVE: We aimed to compare the efficacy of topical pimecrolimus versus hydrocortisone in treating external auditory canal pruritus, using the Modified Itch Severity Scale as an assessment tool. METHODS: We included in the study 40 patients with isolated itching of the external auditory canal who had not received any benefit from previous topical and systemic treatments. Topical 1 per cent pimecrolimus or topical hydrocortisone was applied to each patient's external auditory canal for three months. A Modified Itch Severity Scale was developed and used to assess treatment response. RESULTS: Compared with itching scores on initial assessment, the scores of patients receiving topical pimecrolimus had decreased by 52.3 per cent by the third week of treatment and by 77.6 per cent by the third month, whereas the scores of patients receiving topical hydrocortisone had decreased by 34.4 per cent by the third week and by 64.2 per cent by the third month. CONCLUSIONS: Topical pimecrolimus appears to be as effective as topical hydrocortisone in relieving external auditory canal pruritus. We used a novel scoring system, the Modified Itch Severity Scale, to evaluate external auditory canal pruritus; this is the first self-reporting questionnaire for the quantification of external auditory canal pruritus severity. Further studies are needed to validate this scoring system.