I experience horrible itching in my ears and tonsil area. I was diagnosed with Psoriasis 10 years ago, but it seems that in the past 3 years (I'm 24) that this itching condition has gotten worse (along with my skin condition). I don't accumulate ear wax, I have pain in my ears when exposed to high winds, and I accumulate rather large "greenish" globs in my tonsils. It seems also that when I get these globs, I start to feel sick. I feel worn out, tired, and have cold-like symptoms. Would removing my tonsils help this condition or just make it worse. Is there anything I can do about my ears. My dermatologist has prescribed ear drops in the past, but they haven't helped a bit. By the way, I usually clean out the globs with a water pick (low pressure). Will this cause problems?
Thanks!!!
Answer -----------------
Psoriasis affecting the outer ear and ear canal can be particularly bothersome and it can be very difficult to adequately control symptoms. The most common treatment when the ear canal is affected, is the use of topical steroid preparations in either liquid or cream form. Periodic debridement of epithelial scaling or irrigations of the ear canal may also be necessary.
In regards to the itching in the tonsil region, this is most likely unrelated to psoriasis. A more likely diagnosis would be allergy or chronic tonsillitis, with chronic tonsillitis being more likely. Chronic tonsillitis is generally a condition of adults. The tonsils have crevaces which are called crypts. The crypts may accumulate debris, initially particles of partially digested food. This debris may coagulate and can occasionally even form small crystals or stones. Often the presence of such debris triggers inflammation which may be manifest by symptoms of mild but chronic sore throat or even as the itching you describe. Vigorous oral hygiene measures are the standard recommendation for treatment and include the use of water-pik irrigations as you have described. I will typically recommend the use of a mixture of baking soda and salt in warm water (1/2 tsp of each in approximately 8 oz) which is used for the irrigation. Additionally the use of an antiseptic mouth rinse such as Cepacol is also frequently helpful on a regular basis. These measures are usually required 2-3 times daily if they are to be successful and they must be continued. If these measures fail to alleviate the symptoms after several months, then removal of the tonsils may be a reasonable consideration.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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