What allergies or sensitivities of the ear should be considered when evaluating otitis externa (OE)?

Updated: Mar 09, 2020
  • Author: Ariel A Waitzman, MD, FRCSC; Chief Editor: Ravindhra G Elluru, MD, PhD  more...
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Answer

Atopic dermatitis resulting from sensitivity to topical antibiotic solutions is well known. Neomycin allergy occurs in as many as 5% of patients treated with the medication. Suspect drug sensitivity if worsening of symptoms associated with skin excoriation and weeping occurs in the distribution of the topical medication exposure after the application of drops.

Metal sensitivity also manifests as excoriation, erythema, and edema around the exposure site (eg, a piercing hole). A common allergen is nickel, an impurity that may be present in precious metals. Atopic dermatitis is managed by removal of the allergen (eg, an earring) and beginning topical steroids and antibiotics if the wound is secondarily infected. The diagnosis of metal sensitivity is confirmed by performing a skin patch test.


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