gms | German Medical Science

Introduction: The OE is a nonspecific diffuse inflammation of bacterial, viral or mycotic origin. Eczematous integument changes of the acoustic meatus have an important role to play in the individual disposition. The standard therapy consists in the local application of corticosteroids, antibiotics or antimycotics. Recurrent exacerbation in chronic therapy-resistant OE represents a special challenge for the attending physician. Tacrolimus belongs to a new generation of locally applicable immune modulators, which are successfully used in dermatology for the treatment of inflammatory skin diseases.

Methods: In a prospective clinical study, the effectiveness of Tacrolimus ointment was examined in 40 patients with otherwise therapy-refractory uninfectious chronic OE. Every 2nd (-3rd) day, an ear wick containing Protopic® 0.1% was inserted into the external auditory canal, altogether, the wick was changed three times. Treatment efficiency was evaluated on the basis of re-examinations, a standardized findings sheet and photo-documentation.

Results: The preliminary results show a clear improvement in more than 80% of the cases (33 pat.). In many patients a complete healing of the clinical picture was to be seen. Within the observation period, no relevant local or systemic side effects were observed, except for a local feeling of heat, occasional skin burning (9 pat.) and itching (1 pat.).

Conclusions: The local short-term application of Tacrolimus into the external auditory canal has shown to be an effective and salubrious option in the treatment of chronic therapy-resistant OE. With the corticosteroid-free ointment, which selectively affects the immune system of the skin, even persistent cases with a long lasting course of disease can be treated with promising success.