title: New treatment strategy and assessment questionnaire for external auditory canal pruritus: topical pimecrolimus therapy and Modified Itch Severity Scale.
abstract: 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.
authors.affiliation: Department of Otorhinolaryngology, Kecioren Training and Research Hospital, Ankara, Turkey. drbaranacar@gmail.com
authors.forename: B
authors.initials: B
authors.lastname: Acar
authors.forename: H
authors.initials: H
authors.lastname: Karabulut
authors.forename: Y
authors.initials: Y
authors.lastname: Sahin
authors.forename: M A
authors.initials: MA
authors.lastname: Babademez
authors.forename: A S
authors.initials: AS
authors.lastname: Karadag
authors.forename: R M
authors.initials: RM
authors.lastname: Karasen
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D004424:Ear Canal; D004427:Ear Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016559:Tacrolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; C117268:pimecrolimus; D006854:Hydrocortisone; D016559:Tacrolimus