RAPID RESPONSE FROM BMJ.COM

doi:10.1136/bmjusa.01060006

BMJ, doi: 10.1136/bmjusa.01060006, (Published 5 September 2002)

Letters

RAPID RESPONSE FROM BMJ.COM

Perichondritis after ear piercing

This article originally appeared in BMJ USA

EDITOR $---$ Hanif et al highlight the rising incidence of perichondritis of the pinna after "high" ear piercing. Our own experienceadds further information. We found an incidence of 10 cases overthe period of July 1998 to October 1999 in a population of 320000. Nine patients were female, and all were under 20 years ofage. The auricular abscess took 2-4 weeks to develop after "high"earpiercing.

On aerobic culture, six cases grew Pseudomonas aeruginosa and four cases were sterile. Inappropriate antibiotics were prescribedby general practitioners, the most popular being flucloxacillin(four cases) and erythromycin (two cases). We agree with Hanifet al that this is a case where ciprofloxacin is the antibioticof choice in children despite reports of quinolone causing arthropathyin weight-bearing joints of immature animals.¹

Our inquiries at local beauty salons revealed that a sterile prepacked "gun" designed for piercing the lobule is used for"high" ear piercing. This is inappropriate as the "piston" crushesthe auricular cartilage, allowing subsequent infection with Pseudomonas.

We have found that incision and drainage alone is not adequate treatment. Incision, drainage, and splinting as described byNahl et al for auricular hematomata² isrequired.

Stephen E Kent, consultant otolaryngologist.
(sekent{at}doctors.org.uk)

Ashok V Rokade, locum registrar in otolaryngology.
Koppada Premraj, clinical assistant in otolaryngology.
Christine Butcher, staff nurse.
Warrington Hospital, NHS Trust, UK

1.	British National Formulary. March 2000;39:280.
2.	Nahl SS, Kent SE, Curry AR. Treatment of auricular haematoma by silicone rubber splints. J Laryngol Otol 1989; 103: 1146-1149[Medline].