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Case Report/Case Series |

Chronic Granulomatous Otitis Externa as an Initial Presentation of Cutaneous Crohn Disease ONLINE FIRST

Eileen M. Raynor, MD1
[+] Author Affiliations
1Division of Otolaryngology–Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina
JAMA Otolaryngol Head Neck Surg. Published online July 17, 2014. doi:10.1001/jamaoto.2014.1211
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Importance  In the limited number of Crohn disease cases involving the head and neck, there is a predilection for mucosal surfaces and rare reports of involvement in the postauricular region. To our knowledge, in all previously reported cases involving the head and neck, the patients had a known diagnosis of Crohn disease.

Observations  This case describes a 10-year-old boy with a history of psoriasis and psoriasiform dermatitis who presented with bilateral chronic granulomatous otitis externa, obliteration of the external auditory canal, and fissuring, resulting in separation of the lobule from the preauricular skin.

Conclusions and Relevance  Pathologic examination results were consistent with granulomatous dermatitis concerning for cutaneous Crohn disease, and a subsequent gastroenterologic workup confirmed the diagnosis of Crohn disease. This is a report of chronic granulomatous otitis as the initial presentation of cutaneous Crohn disease in a child.

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Figure 1.
Right External Ear

Right ear, demonstrating stenosis of the external auditory canal and fissuring of the preauricular crease.

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Figure 2.
Left External Ear

Left ear, demonstrating erythema of the helix superiorly and scarring inferiorly along the preauricular crease and lobule.

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