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ENT · Ear and audiology: eczematous otitis externa
Sample itemA 35-year-old man with seborrhoeic dermatitis has itchy, flaky skin in both ear canals for months. There is no pain or discharge and the drums are normal. Which treatment is most appropriate?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Short course of a topical steroid with aural toilet
Chronic eczematous otitis externa is a dermatitis, and topical steroid with gentle cleaning and avoiding scratching or water brings relief. Antibiotics are reserved for infection. Syringing leaves the canal wet and worsens the skin.
Option by option
A. Short course of a topical steroid with aural toilet (correct)
Correct. Eczematous canal skin responds to a topical steroid with gentle aural toilet.
B. Systemic antibiotic for ten days
Systemic antibiotics are unnecessary as there is no pain, discharge or infection.
C. Oral antifungal for six weeks
Oral antifungals are for proven fungal infection and no fungal debris is described.
D. Repeated syringing with water
Water syringing macerates the skin and can worsen the dermatitis.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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