Eczematous diseases such as atopic dermatitis, seborrhoeic dermatitis, allergic and irritant contact dermatitis may cause lesions of the ear and the acoustic meatus.
Clinical picture: Erythema and scaling behind the ears, sometimes with fissuring, is characteristic for atopic dermatitis, but may also occur in allergic or irritant contact dermatitis. Erythema, oedema, scaling and possibly oozing may also occur involving the auricle and/ or the acoustic meatus. Lesions localised on the earlobe may be a sign of nickle allergy if nickelous jewellery is worn.
Diagnosis: The diagnosis is based on careful history taking, clinical examination and further testing such as prick and patch testings if atopy or allergy are suspected.
Differential diagnoses: Erysipelas, zoster oticus and relapsing polychondritis are possible differential diagnoses of lesions of the auricle. Bacterial, viral and mycotic otitis externa and psoriasis have to be taken into account if lesions of the acoustic meatus are present.