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Foot and Ear Disease‐The Dermatophytid Reaction in Otology
Author(s) -
Derebery M. Jennifer,
Berliner Karen I.
Publication year - 1996
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199602000-00014
Subject(s) - medicine , otology , trichophyton , dermatology , dermatophyte , immunotherapy , otitis , surgery , immunology , immune system , antifungal
Chronic otitis externa (COE) is occasionally refractory to treatment and may persist for years. In such cases, a dermatophytid (id) reaction from a fungal infection in a remote location should be suspected. Immunotherapy with dermatophyte ( Trichophyton, Oidiomycetes, and Epidermophyton [T.O.E.]) extracts and dust mite, based on serial endpoint titration skin test results, as well as a yeast elimination diet is the treatment of choice. Fourteen cases of id reaction are described. The primary fungal source was not always obvious, but immunotherapy and diet led to complete resolution of the COE in 8 cases (57.1%) and improvement in another 3 cases (21.4%). Some case reports illustrate presentation, treatment, and outcome.