{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T14:29:33Z","timestamp":1779114573653,"version":"3.51.4"},"reference-count":28,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T00:00:00Z","timestamp":1632268800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015098","name":"Seoul Metropolitan Government Seoul National University Boramae Medical Center","doi-asserted-by":"publisher","award":["04-2018-0290"],"award-info":[{"award-number":["04-2018-0290"]}],"id":[{"id":"10.13039\/501100015098","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Although pruritic external auditory canal (PEAC) is a relatively common symptom, particularly in the geriatric population, its pathophysiology and appropriate treatment remain to be elucidated. We compared the therapeutic efficacy of pimecrolimus, a topical calcineurin inhibitor (CI), and a moisturizing cream (MC) in patients with PEAC. Thirty-nine patients (73 ears) were prospectively enrolled and treated topically twice daily with the CI (n = 20, 39 ears) or the MC (n = 19, 34 ears) for two weeks. The change in itching sensation was evaluated subjectively using a self-questionnaire at immediately, one month, and two months after self-application, and objectively by changes in erythema grading. Although topical treatment with the CI resulted in a more rapid improvement than treatment with the MC in patients with PEAC, the final outcomes did not differ between the groups. Furthermore, similar improvements in erythema scores were noted. The results of this study suggest that the MC, which rejuvenates the normal physiological status of the ear canal skin, may greatly benefit those elderly patients more susceptible to PEAC, without any concerns about adverse events and underlying comorbidities. Expanding upon the understanding of the role of moisturizers in the treatment of pruritic ears merits attention, as this knowledge provides a good example of the clinical guidelines for the management of PEAC.<\/jats:p>","DOI":"10.3390\/jcm10194313","type":"journal-article","created":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T22:50:48Z","timestamp":1632351048000},"page":"4313","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of Therapeutic Effects of Topical Calcineurin Inhibitor and Moisturizing Cream on Pruritic External Auditory Canal"],"prefix":"10.3390","volume":"10","author":[{"given":"Sang-Yeon","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea"},{"name":"Medical Research Center, Sensory Organ Research Institute, Seoul National University, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2468-485X","authenticated-orcid":false,"given":"Soyun","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4612-7624","authenticated-orcid":false,"given":"Minju","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9440-9744","authenticated-orcid":false,"given":"Dong-Han","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, Konkuk University Medical Center, Seoul 05030, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/S0030-6665(20)31815-6","article-title":"Allergic disorders in the otolaryngologic practice","volume":"18","author":"King","year":"1985","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1017\/S0022215110002161","article-title":"Isolated itching of external auditory canal: Clinicopathological study with immunohistochemical determination of antimicrobial peptides","volume":"125","author":"Acar","year":"2011","journal-title":"J. Laryngol. Otol."},{"key":"ref_3","unstructured":"Kroon, D.F., and Strasnick, B. (2003). Diseases of the auricle, external auditory canal, and tympanic membrane. Surgery of the Ear, BC Decker. [5th ed.]."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1288\/00005537-197608000-00008","article-title":"The human external auditory canal secretory system\u2014An ultrastructural study","volume":"86","author":"Main","year":"1976","journal-title":"Laryngoscope"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"321","DOI":"10.21053\/ceo.2017.00129","article-title":"Substance P and Calcitonin Gene-Related Peptide in the Glands of External Auditory Canal Skin","volume":"10","author":"Yoon","year":"2017","journal-title":"Clin. Exp. Otorhinolaryngol."},{"key":"ref_6","first-page":"333","article-title":"Treatment of itching ears with fluocinolone acetonide","volume":"53","author":"Mabry","year":"1974","journal-title":"Eye Ear Nose Throat. Mon."},{"key":"ref_7","first-page":"151","article-title":"Itching In The Ear Canal Due To Hypocerumenosis\u2014An Effective Method of Treatment","volume":"98","author":"Seftel","year":"1963","journal-title":"Calif. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1034\/j.1600-0846.2001.70203.x","article-title":"Corticosteroid-induced atrophy and barrier impairment measured by non-invasive methods in human skin","volume":"7","author":"Kolbe","year":"2001","journal-title":"Skin Res. Technol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1017\/S0022215114001510","article-title":"Investigation of demodex species frequency in patients with a persistent itchy ear canal treated with a local steroid","volume":"128","author":"Cevik","year":"2014","journal-title":"J. Laryngol Otol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.amjoto.2015.02.003","article-title":"An objective analysis of sebum, pH and moisture levels of the external ear canal skin","volume":"36","author":"Tuzuner","year":"2015","journal-title":"Am. J. Otolaryngol."},{"key":"ref_11","first-page":"33","article-title":"Microbiology of the external auditory canal in patients with asteatosis and itching","volume":"11","author":"Arda","year":"2003","journal-title":"Kulak Burun Bogaz Ihtis. Dergisi KBB J. Ear Nose Throat"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1097\/01.mlg.0000231562.83733.53","article-title":"Topical pimecrolimus 1% for the treatment of pruritic external auditory canals","volume":"116","author":"Djalilia","year":"2006","journal-title":"Laryngoscope"},{"key":"ref_13","first-page":"618","article-title":"The macrolide immunosuppressants in dermatology: Mechanisms of action","volume":"12","author":"Marsland","year":"2002","journal-title":"Eur. J. Dermatol. EJD"},{"key":"ref_14","first-page":"187","article-title":"Evaluation of contact sensitivity in patients with isolated itching of the external auditory canal","volume":"40","author":"Acar","year":"2011","journal-title":"J. Otolaryngol. Head Neck Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1017\/S0022215109991459","article-title":"New treatment strategy and assessment questionnaire for external auditory canal pruritis: Topical pimecrolimus therapy and Modified Itch Severity Scale","volume":"124","author":"Acar","year":"2010","journal-title":"J. Laryngol. Otol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1017\/S0022215116008744","article-title":"Therapeutic effect of Castellani\u2019s paint in patients with an itchy ear canal","volume":"130","author":"Babakurban","year":"2016","journal-title":"J. Laryngol. Otol."},{"key":"ref_17","first-page":"e14471","article-title":"Successful treatment of erythematous-squamous disorders of the external auditory canal with tacrolimus and clotrimazole in otic oil: Our experience in 25 patients","volume":"36","year":"2020","journal-title":"Dermatol. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.jid.2020.11.006","article-title":"Inflammaging and the Skin","volume":"141","author":"Pilkington","year":"2021","journal-title":"J. Investig. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.molmed.2010.03.003","article-title":"Inflammatory networks during cellular senescence: Causes and consequences","volume":"16","author":"Freund","year":"2010","journal-title":"Trends Mol. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/j.1365-2133.2005.06966.x","article-title":"Correlation between age and the secretions of melanocyte-stimulating cytokines in cultured keratinocytes and fibroblasts","volume":"153","author":"Okazaki","year":"2005","journal-title":"Br. J. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1046\/j.1365-2133.2002.04549.x","article-title":"Tumour necrosis factor-\u03b1-induced migration of human Langerhans cells: The influence of ageing","volume":"146","author":"Bhushan","year":"2002","journal-title":"Br. J. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1016\/j.jid.2018.10.036","article-title":"Epidermal barrier function is impaired in langerhans cell-depleted mice","volume":"139","author":"Lee","year":"2019","journal-title":"J. Invest. Dermatol."},{"key":"ref_23","first-page":"1","article-title":"Immunological and non-immunological mechanisms of allergic diseases in the elderly: Biological and clinical characteristics","volume":"14","author":"Belluzzo","year":"2017","journal-title":"Immun. Ag."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1080\/14656566.2020.1729738","article-title":"Pharmacological management of atopic dermatitis in the elderly","volume":"21","author":"Howell","year":"2020","journal-title":"Exp. Op. Pharmacother."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"752","DOI":"10.5114\/ada.2019.91425","article-title":"Efficacy and safety of topical calcineurin inhibitors for the treatment of atopic dermatitis: Meta-analysis of randomized clinical trials","volume":"36","author":"Pawliczak","year":"2019","journal-title":"Adv. Dermatol. Allergol. Post. Dermatol. Alergol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.ijpharm.2003.07.013","article-title":"Percutaneous absorption of drugs used in atopic eczema: Pimecrolimus permeates less through skin than corticosteroids and tacrolimus","volume":"269","author":"Billich","year":"2004","journal-title":"Int. J. Pharm."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/S0030-6665(20)30312-1","article-title":"The external auditory canal: Anatomy and physiology","volume":"29","author":"Kelly","year":"1996","journal-title":"Otolaryngol. Clin. North Am."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1111\/j.1524-4725.1990.tb01554.x","article-title":"Histologic changes in skin associated with aging","volume":"16","author":"Kurban","year":"1990","journal-title":"J. Dermatol. Surg. Oncol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/19\/4313\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:03:24Z","timestamp":1760166204000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/19\/4313"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,22]]},"references-count":28,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2021,10]]}},"alternative-id":["jcm10194313"],"URL":"https:\/\/doi.org\/10.3390\/jcm10194313","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,9,22]]}}}