• An individual case of external otitis should not be considered to be idiopathic until it has been shown that a definitive diagnosis cannot be made. Establishment of an etiological diagnosis can be facilitated by clues derived from a careful history (e.g., dermatitis of other areas) and extensive clinical and laboratory examination (e.g., biopsy, if indicated). A dermatitis of the external auditory canal can represent the first manifestation of a systemic disease. Therapeutic success often depends on the physician's ability to interpret the anamnestic, clinical, and laboratory findings.
Perry ET. A PRACTICAL APPROACH TO EXTERNAL OTITIS. JAMA. 1957;163(3):161–164. doi:10.1001/jama.1957.02970380003002
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