Week 1

Question 1

LICHEN SIMPLEX CHRONICUS

Answer 1

Outer Ear. (Neurodermatitis ) Itch/scratch cycle continues after initial insult such as bug bite. Most commonly found in outer canal and concha. Treatment: education, cut nails, soothing lotion

Question 2

SEBORRHEIC DERMATITIS

Answer 2

Outer Ear. Scaly Erythema & lesions on scalp and eyebrows

Question 3

CONTACT DERMATITIS

Answer 3

Outer Ear. Irritants to ear, such as perfume and earrings (nickel)

Question 4

ATOPIC DERMATITIS

Answer 4

Outer Ear. Atopic Patient (eczema, asthma, hayfever). Look for lesion on flexion folds, ear canal. Can be confused with otitis externa, but is sterile, no WBC, not infected

Question 5

ACUTE CELLULITIS OR ERYSIPELAS

Answer 5

Outer Ear. Secondary to another dermatitis or trauma. Cellulitis involves the deeper dermis and subcutaneous fat; erysipelas involves the upper dermis and superficial lymphatics. Cellulitis may present with or without purulence; erysipelas is nonpurulent
Erysipelas can spread along facial planes and involve the entire auricle. Patient will systemic symptoms- fever, chills.

Question 6

INFECTIOUS CHONDRITIS

Answer 6

Outer Ear. Deeper infection involving cartilage usually follows erysipelas. Entire ear red, hot, including lobe. Also systemic symptoms: fever, nausea, chills.

Question 7

RELAPSING POLYCHONDRITIS

Answer 7

Outer Ear. Non-infectious systemic disease, bilateral auricular chondritis. Redness comes not from skin, but deeper; possibly autoimmune; Will have other symptoms, such as nasal chondritis, ocular chondritis or arthritis; *Spares the lobes; Redness is only where there is cartilage.

Question 8

TRAUMA- AURICULAR HEMATOMA

Answer 8

Outer Ear. Auricular hematoma occurs after direct trauma to the ear, typically during sports (eg, rugby, wrestling, boxing, or mixed martial arts). If the hematoma is not drained, disruption of blood supply to the auricular cartilage causes necrosis, increases the chance of infection, and usually results in a cauliflower ear. Treatment: remove fluid with 18g needle & 10 cc syringe, or excision, then cover with compression dressing for 48 hrs. Athletes should be encouraged to use protective headgear to prevent recurrence.

Question 9

OTITIS EXTERNA (Generalized)
in the ear canal

Answer 9

Risk factors: Change in pH from acid to alkaline; Increased temperature and humidity; Mild Trauma, frequent cleaning

History: swimming, trauma & dermatitis. Q-tip abuse

Signs and symptoms: Tender swollen ear canal, auricle very tender to manipulation. Symptoms can range from pruritis to severe pain. Blockage of the auditory canal cause the patient to complain of aural fullness and loss of hearing. May be one-sided or bilateral. Severe pain can prevent sleep.

Physical exam: red ear canal, exudate, may be swollen shut, fever. Pain is much worse from manipulation of the auricle and tragus.