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Key Clinical Message: Embedded earrings in adults have been reported to be a possible cause of erosive oral lichen planus. Erosive lichen planus is rare and its cause cannot be determined. Embedded earring in the earlobes is rare clinical presentation in adult. The concurrent nature of these two conditions has not been previously, described in the published literature. Unexpectedly, we removed the earring from the earlobe and successfully treated erosive oral lichen planus. We hypothesized that prolonged embedded earring is a possible factor that induced erosive lichen planus in this case. [ABSTRACT FROM AUTHOR]

Key Clinical Message Embedded earrings in adults have been reported to be a possible cause of erosive oral lichen planus. Abstract Erosive lichen planus is rare and its cause cannot be determined. Embedded earring in the earlobes is rare clinical presentation in adult. The concurrent nature of these two conditions has not been previously, described in the published literature. Unexpectedly, we removed the earring from the earlobe and successfully treated erosive oral lichen planus. We hypothesized that prolonged embedded earring is a possible factor that induced erosive lichen planus in this case.

Background: Daith piercing is a special ear‐piercing method that punctures the crus of the helix. The penetrated site at the ear's innermost point is assumed to stimulate a pressure point associated with the vagus nerve. It has been reported that the pierced spot relieves migraine and tension‐type headaches by activating vagal afferents, leading to the inhibition of neurons in the caudal trigeminal nucleus via the nucleus tractus solitarii. Objective: The objective of this narrative literature review is to summarize the current state of knowledge concerning daith piercing for the treatment of migraine and tension‐type headaches from the perspectives of the Chinese and Western auricular systems. Methods: PubMed and China National Knowledge Infrastructure databases were searched using the keywords "daith piercing," "auricular points," "headache," and "acupuncture" from database inception to September 1, 2023. Only studies on humans were eligible; otherwise, no further restrictions were applied to the study designs, type of headache, or patient population of the identified articles. Bibliographies of all eligible studies were screened for further eligible studies. The main outcome of interest was a quantitative measure of pain relief by daith piercing. Secondary outcomes were relapse time of headache and further outcomes related to daith piercing, if available. Results: From a total of 186 identified articles, one retrospective study and three case reports fulfilled the inclusion criteria. No clinical trial was identified. The obtained studies describe patients experiencing chronic headaches undergoing daith piercing without changing or reducing their usual medication. In all case studies and the retrospective study, patients reported substantial reductions in pain immediately after daith piercing; however, headache symptoms recurred several weeks to months thereafter. From the perspective of the Chinese and Western auricular systems, no sufficient explanation for the described treatment effect of daith piercing was found. Conclusion: The available literature, combined with the reported recurrence of pain as well as the associated side effects of daith piercing, indicate that current evidence does not support daith piercing for the treatment of migraine, tension‐type headaches, or other headache disorders. Plain Language Summary: This paper summarizes what we know about Daith piercing (DP) for chronic migraine and tension‐type headache and discusses how DP might work. Current evidence does not support DP as an effective treatment of chronic migraine and tension‐type headache. These findings might assist clinicians in discussing this subject with patients as well as guide future research. Plain Language Summary: This paper summarizes what we know about Daith piercing (DP) for migraine and tension‐type headache and discusses how DP might work. Current evidence does not support DP as an effective treatment of migraine and tension‐type headache. These findings might assist clinicians in discussing this subject with patients as well as guide future research. [ABSTRACT FROM AUTHOR]

Background: Ear piercings are a common practice for body modification and self-expression, but they can lead to various complications, including embedded jewelry, infections, and difficulty removing earring backings. Traditional techniques for removing stuck backings involve forceful manipulation, resulting in pain, scarring, and suboptimal cosmetic outcomes. Discussion: In this technique description, we present an alternative atraumatic technique for the removal of stuck ear-piercing backings. The technique involves injecting a mixture of local anesthetic and a vasoconstrictor, around the backing to create a fluid pocket that loosens the earring post. A special maneuver is then applied using a needle driver allowing for easy gentle removal. If the backing remains embedded, gentle pressure on the earlobe reveals a loop that can be threaded with a syringe needle to propel the backing out. Conclusions: The proposed atraumatic technique for removing stuck ear-piercing backings offers a satisfactory and less stressful experience for pediatric patients while reducing the need for emergency department referrals. Given the lack of consensus on extraction methods, this technique provides a valuable alternative in the absence of a widely agreed-upon approach. Further research is needed to establish standardized protocols. Nevertheless, adopting this technique has the potential to enhance patient satisfaction and improve outcomes.

Background: Ear keloids form after ear piercing in genetically predisposed young adults, causing cosmetic disfigurement and negative psycho-social impact, and reducing quality of life. Total excision of ear keloids leads to loss of ear tissue distorting ear framework and reconstruction to restore esthetically pleasant ear causes scarring and more aggressive keloids. Rate of recurrence is higher than 80% when surgical excision alone is done. Aims and Objectives: The study was conducted to compare the efficacy of intralesional triamcinolone acetonide (TAC) or 5-fluorouracil (5 FU) as monotherapy, combined TAC+5 FU and multi-modal therapy (TAC+5 FU+surgical excision) for keloids of the ear. Materials and Methods: The prospective comparative study included 30 patients who presented to the out-patient clinic of plastic surgery department of Government Mohan Kumaramangalam Medical College Hospital, Salem for a duration of 2 years from January 2021 to December 2022. Patients were categorized into three groups based on size of ear keloids, Group I (10) – Injection TAC (A) or 5- FU (B), Group II (10): Injection TAC+5-FU, and Group III (10): Injection TAC+5- FU+Surgical excision (A – neoadjuvant+adjuvant; B – only adjuvant). Results: Of a total of 30 patients, Group IIIA showed significant reduction of keloid with least side effects, most pleasing cosmetically (Patient and observer scar assessment scale 1/10). No recurrence in follow up. Conclusion: Multi-modal therapy consisting of neoadjuvant TAC+5-FU, surgical excision, and adjuvant TAC+5 FU offers the best long-term results for large ear keloids.

Background: Ear keloids form after ear piercing in genetically predisposed young adults, causing cosmetic disfigurement and negative psycho-social impact, and reducing quality of life. Total excision of ear keloids leads to loss of ear tissue distorting ear framework and reconstruction to restore esthetically pleasant ear causes scarring and more aggressive keloids. Rate of recurrence is higher than 80% when surgical excision alone is done. Aims and Objectives: The study was conducted to compare the efficacy of intralesional triamcinolone acetonide (TAC) or 5-fluorouracil (5 FU) as monotherapy, combined TAC+5 FU and multi-modal therapy (TAC+5 FU+surgical excision) for keloids of the ear. Materials and Methods: The prospective comparative study included 30 patients who presented to the out-patient clinic of plastic surgery department of Government Mohan Kumaramangalam Medical College Hospital, Salem for a duration of 2 years from January 2021 to December 2022. Patients were categorized into three groups based on size of ear keloids, Group I (10) - Injection TAC (A) or 5-FU (B), Group II (10): Injection TAC+5-FU, and Group III (10): Injection TAC+5-FU+Surgical excision (A - neoadjuvant+adjuvant; B - only adjuvant). Results: Of a total of 30 patients, Group IIIA showed significant reduction of keloid with least side effects, most pleasing cosmetically (Patient and observer scar assessment scale 1/10). No recurrence in follow up. Conclusion: Multi-modal therapy consisting of neoadjuvant TAC+5-FU, surgical excision, and adjuvant TAC+5 FU offers the best long-term results for large ear keloids. [ABSTRACT FROM AUTHOR]

The article deals with the legal requirements for cosmetic procedures on minors, especially tattoos, piercings, and beauty treatments. It explains that the capacity to consent and written consent from the legal guardians are necessary for such procedures. The legal regulations for piercings and tattoos on minors are explained, including the disclosure of risks and contraindications. It is determined that written consent from the person to be pierced or tattooed, as well as from the legal guardians, is required. Piercings may be done starting from the age of 14, while tattoos may only be done from the age of 16. Aesthetic treatments and surgeries may only be performed on mature minors who have reached the age of 16. [Extracted from the article]

Objective: Tetanus remains a major public health problem in the developing countries despite the availability of active immunization and passive immunization since long. Non-sterile ear piercing and instrumentation pose a constant threat of developing tetanus associated with morbidity and mortality. Study Design: Retrospective Cross-sectional study. Setting: Department of Pediatric, Bahawal Victoria Hospital Bahawalpur. Period: June 2019 to June 2022. Material & Methods: The data of children admitted with tetanus following ear piercing, ear cleaning/instrumentation and chronic ear discharge was collected. The data included their age, gender, history of ear piercing, instrumentation and chronic ear discharge (otorrhea), duration between piercing/instrumentation and development of signs & symptoms of tetanus, history of tetanus vaccination (during routine childhood EPI vaccination), history of tetanus toxoid administration after the causative event, residence, socioeconomic status, education status of parents and outcome of cases. Results: Total 17 cases of otogenic tetanus (tetanus following ear piercing, ear instrumentation and with chronic otorrhea) were admitted in pediatric department of the hospital during study period. Age range was between 03 to 13 years with mean age 7.71+2.80 years. Of these cases, there were 12 females (70.6%) and 5 males (29.4%). Nine cases developed tetanus after ear piercing, five cases developed tetanus following ear instrumentation and three cases had history of chronic ear discharge. Conclusion: Tetanus is an uncommon but dreadful complication of non-sterile ear piercing, ear instrumentation and chronic discharging ears in chronic otitis media, and is still occurring in our country. [ABSTRACT FROM AUTHOR]

BackgroundVasovagal reactions are common amongst patients with a fear of needles receiving injections or during venipuncture, but they are rarely studied in healthy people undergoing earlobe piercing. The purpose of this prospective study was to evaluate the incidence and the features of vasovagal reactions observed during earlobe piercing.MethodsThousand eight hundred and sixty six participants aged older than 13 years had their earlobes pierced in our department from January 2020 to January 2022. When vasovagal reactions occurred during the procedure (e.g., dizziness, pallor, diaphoresis, and faintness, etc.), they were recorded and more detailed demographic information was collected.ResultsA total of 196 cases of vasovagal reactions were reported in females amongst 1,866 participants, including 58 who actually lost consciousness during earlobe piercing. The incidence of vasovagal reactions and vasovagal syncope was 10.5 and 3.11% respectively. All syncopal reactions occurred in persons younger than 30 years.ConclusionVasovagal syncope is often very sudden and occurs without warning. Practitioners need to be familiar with these reactions, and prevent people from an unpredictable fall and subsequent injury during ear piercing.

Abstract Pankaj Vats Introduction Multiple modalities exist for treating keloids ranging from surgical, medical, chemotherapeutic, and radiation therapy. Different techniques of radiation therapy have been used to treat keloids as an adjuvant to surgical excision. With this case series, we report our experience of using electron beam radiation therapy in this setting. Materials and Methods We retrospectively analyzed 16 ear keloids treated in 10 patients from January 2013 to October 2015 with surgical excision followed by electron beam to a dose of 10 Gy in two fractions over two consecutive days in immediate postoperative period. Patients were evaluated for recurrent lesions, cosmesis, and adverse effects. Results With a median follow-up of 78 months (range: 67–100 months), recurrent lesion was seen in five cases; a local control rate of 68.75% was seen. Median recurrence-free period was 67 months (range: 12–100 months). Acceptable cosmesis was seen in all cases and no acute or chronic adverse effects were seen. Conclusion The large follow-up period in our series establishes the role of electron beam radiation therapy in attaining long-term control in keloid patients. The lower total dose with higher dose per fraction used in our patients has acceptable control along with good cosmesis and absent adverse effects.

Background: Cutaneous pseudolymphoma (CPL) refers to a group of benign, reactive processes that mimic cutaneous lymphoma and are associated with a variety of triggering immune stimuli, including arthropod bites, drugs, and foreign bodies. In children, most cases of CPL are due to a variant of Borreliosis that is specific to Eurasia. Cutaneous pseudolymphoma secondary to ear piercing has only been documented in adults. Case Reports: We present the clinical and pathological findings of cutaneous Bcell psuedolymphoma in two adolescent patients (11-year-old female and 15-year-old male) secondary to ear piercing. Conclusion: Our report expands the clinico-pathological spectrum of CPL associated with ear piercing by documenting its occurrence in children. [ABSTRACT FROM AUTHOR]

Background: The prevalence of ear piercings is 8%-32%. Complications can be due to the factors such as the amount of tissue blood supply, the location of the piercing, the extent of hygiene techniques, and much more. Materials and Methods: A total of 586 females (age, 18-28 years) in Riyadh, Saudi Arabia, with at least one ear piercing were included in this analytical cross-sectional study by convenience sampling from September 2019 to April 2020. A link to an Arabic web-based questionnaire was distributed through social media (WhatsApp, Twitter, and Snapchat). It included questions related to both earlobe and ear cartilage piercings. Bivariate statistical tests were carried out. Results: The prevalence of a probable ear piercing-related infection for ear cartilage piercings was found to be significantly higher than for earlobe piercings (41.4% vs. 29.6%) (P = 0.0004) (confidence interval [CI] = 0.443-0.795). A significant association between piercing type (3.3% of earlobe piercings and 8.1% of ear cartilage piercings) and scar formation was observed (P = 0.0002) (CI = 0.209-0.722). The prevalence of ear piercing complications among participants who used piercing needles was lower for both earlobe piercings and ear cartilage piercings (3.65%, 8.75%) (P = 0.0015) than among those who used piercing guns (37.9%, 43.4%) (P = 0.114). Conclusion: Probable external ear infections were more common among those with cartilage ear piercings than those with earlobe piercings. Future studies should include participants of a broader age category and in different locations in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Introduction: Lupus vulgaris is the most common form of cutaneous tuberculosis caused by contiguous spread from an underlying infective focus or lymphatic or hematogenous spread. It can also develop at the site of direct inoculation (e.g., tattooing and ear piercing) or Bacillus Calmette-Guerin vaccination. The solitary involvement of the pinna is rare and may face clinicians with a diagnostic dilemma. Herein, we reported the case of a 37-year-old female presenting with lupus vulgaris of the left pinna with a history of ear piercing. Case Report: Our case was a 37-year-old female presenting with asymptomatic erythematous plaques on the left pinna for 2 years. She had a history of ear piercing done 20 years ago. After 6 months of ear piercing, she suffered from recurrent infections at the site of piercing in the left ear, while the other ear was normal. Two years earlier, she developed a small erythematous papule, which slowly progressed in size to the present status. On examination, well-defined erythematous scaly plaques were noted on the left helix. The histopathology of the skin biopsy showed multiple confluent granulomas consisting of the epithelioid cells and lymphocyte with a focal area of necrosis in the dermis. Acid-fast bacilli were not seen in modified Ziehl-Neelsen (ZN) and routine ZN staining. A final diagnosis of lupus vulgaris was made, and the patient was started on antitubercular drugs. There was a significant resolution of the lesion after 2 months of treatment. Conclusion: Cutaneous tuberculosis should be considered in the differential diagnosis of chronic nonhealing granulomatous skin lesions developing at the site of ear piercing.

Ear piercing is a simple office procedure commonly done in India for traditional purposes and after repair of the split ear lobule and ear lobule reconstruction. Multiple methods have been described, but the main goals of any procedure are that it should be simple, easily reproducible, inexpensive, and accurate and should allow the formation of a neat straight tract without complications, most commonly infection. We have devised a simple and reproducible method for ear piercing using an easily available, sterile intravenous cannula. The cannula creates a precise hole, and the earring can be easily threaded through the sheath after removing the needle. This method of piercing mitigates the risk of infection normally associated with the procedure especially when done through cartilage. The same technique can also be used in children with a slight modification as described in the article. [ABSTRACT FROM AUTHOR]

Background: The reported health and socioeconomic consequences of ear piercing, especially in modern day society, underscore the need to further research into this subject. In this study, we determine the trends and complications of ear piercing among selected Nigerian population. Aim and Objectives: The aim and objective of this study was to draw attention to the trends and complications of ear piercing with a view to prevent its associated complications. Methodology: It is a descriptive cross-sectional study carried out between February and May 2015 among selected Nigerian population from two of its six geo-political zones. A self-administered semi-structured questionnaire which had been pretested was used to collect data from 458 respondents who consented using multistage sampling technique. Results: Of 480 respondents enumerated, 458 completed the questionnaires and gave their biodata. The male:female ratio was 1:6.2. Their ages ranged from 18 to 75 years with a mean of 35.56 ± 10.16. About 35.4% of the respondents were within the age group of 31–40 years. Majority of the respondents, i.e.,79.3% practiced ear piercing on their children. Most of them (86.8%) preferred single piercing. Ear piercing was performed within the 1st week of birth in 37.2% of the respondents. Large percentage (93.2%) of the respondents will not encourage ear piercing in male children. Nearly 20.5% of the respondents observed complications. Conclusion: Ear piercing remained a common practice in Nigeria, with respondents preferring it on females. Majority of the piercings are done in childhood and by untrained personnel. Keloid formation was the notable complication observed by the respondents. There is a need to increase awareness about the hazards of ear piercings and to enact laws that regulate ear piercings particularly in children which is hereby stretched.

INTRODUCTION: Body piercing is a modification, which is very popular, especially among young people. It is a form of puncturing the tissues and placing jewelry in created openings. Commonly pierced parts of body are nose, navel, tongue, lips, eyebrow, nipples, and genitals. OBJECTIVES: The aim of this paper was to describe the possible body areas that can be pierced and to check which of them are the most common. Also we would like to show the spectrum of complications that can occur after such procedures especially in the group of people with oral piercings. MATERIAL AND METHODS: We examined two hundred people with piercing in the area other than earlobe, who agreed to complete anonymous questionnaire. All people were Polish nationals, aged between 18 and 40 years. Participation in the study was voluntary. The questionnaire contained questions regarding age, gender, place of origin, number of ornaments, their placement, and the occurrence of complications (early and late) after body piercing procedures. RESULTS: The most frequently pierced part of the body was the ear (81.5%). Wound healing and redness were the most common problems associated with piercing. Among people with oral piercing, the most frequent complications occurred in the lip, and included swallowing of ornament, hypersensitivity, abrasion, and chipped teeth as well as gingival recessions. CONCLUSIONS: Swallowing of the jewelry is the most common complication caused by oral piercing. The ear is the most frequently pierced area and it is exposed to the most of complications. Piercing procedures are not safe for health and doctors should inform all patients with piercings about possible complications. [ABSTRACT FROM AUTHOR]

Chrysosporium is a large genus of saprophytic fungi that is commonly found in the soil. Infection caused by this organism is rare in humans and typically occurs in immunocompromised patients. Primary cutaneous Chrysosporium infection is relatively rare and has been reported in a heart transplant patient. The prognosis is usually favorable, but very poor in the setting of persistent profound immunosuppression. We herein report a case of primary cutaneous Chrysosporium infection following ear piercing in an immunocompetent patient. It is important for clinicians to consider this condition in patients with slow-onset skin and soft tissue infection following cutaneous injury, even in an immunocompetent setting.

Ear recognition is an emerging research area in image‐based biometrics. The commercial availability of lenslet light field cameras able to capture full spatio‐angular information has brought momentum to biometric and forensic research exploiting this new type of imaging sensors. This study is the first to consider the usage of light field cameras for ear recognition, proposing both an appropriate content database and an ear recognition solution. The novel Lenslet Light Field Ear DataBase (LLFEDB) includes 536 light field images corresponding to four different poses, from 67 subjects, captured with a Lytro ILLUM lenslet light field camera. The LLFEDB includes critical cases such as ear images partly occluded by ear piercing, earing, hair and combination of occlusions. The novel light field‐based ear recognition solution proposed exploits the richer spatio‐angular information available in the light field images. A comparative performance evaluation study using the LLFEDB, and focusing on the most recent light field and non‐light field based descriptors for ear recognition, shows a very promising performance of the proposed descriptor, outperforming all the assessed descriptors. [ABSTRACT FROM AUTHOR]

BACKGROUND Surgeons often come across split earlobe (SEL) deformities in their clinical practice which usually result from wearing heavy earrings for a long duration. It is of utmost importance to achieve a satisfactory repair with increased strength in one go. OBJECTIVE To describe a strong repair for partial SEL with preservation of the orifice. MATERIALS AND METHODS This study is a retrospective review of 25 patients (36 earlobes), who underwent repair of partial SEL deformity with an orifice preserving double opposing Z-plasty in the hospital, from January 2014 to June 2015. The duration of follow-up was 12 months. RESULTS Adequate cosmetic results were obtained in all patients with no need for revision surgery due to recurrence or scar dehiscence. Patients did not report any difficulty in wearing earrings and were satisfied with the aesthetic outcome. CONCLUSION The orifice preserving double opposing Z-plasty technique seems to offer an efficacious method of repair of partial SEL deformity with an acceptable scar. The technique is simple and reproducible with good aesthetic outcomes and minimal complications. [ABSTRACT FROM AUTHOR]

Background: Keloid is an abnormal growth of scar at the site of skin injury, which usually does not regress. It proliferates beyond the original scar. The ear keloid usually develops after piercing injury to wear ornaments. A patient usually asks for removal of keloid, as it is aesthetically unpleasant. Patient may sometimes complain of itching and pain. Aim: The study was conducted to analyze results following excision of keloid with its tract and topical silicone gel as the postsurgical adjuvant. Materials and Methods: Ear keloids measuring less than 0.5 cm or more than 5 cm in maximum dimension were excluded from the study. Nonpiercing causes such as burns, trauma, and recurrent keloid were excluded from the study. The study was carried out on 22 patients who had keloid because of piercing injury, including 4 cases with both ear keloids. Of 26 ear keloids, 19 had the tract or connecting tissue. The lesion was excised under anesthesia using magnification. For all the operated cases, topical liquid silicone gel was used as postsurgical adjuvant therapy. The method of application of topical silicone gel was taught to each patient and was considered significant. Result: The magnification helped in identification of tract in 73% of the cases in this study. Twenty patients had successfully responded to proposed treatment, and two patients developed recurrence while using topical silicone gel as the adjuvant. These two patients were managed with conventional triamcinolone injection. Conclusion: The topical silicone gel as postsurgical adjuvant therapy avoided the use of painful postsurgical injection or radiotherapy for the 1-3 cm primary ear keloids. The advantages of magnification were better clearance of keloid tissue, easier identification of tract and removal of keloid pseudopods, meticulous suturing, and comfortable elevation of a small local flap. [ABSTRACT FROM AUTHOR]

Background: Keloid is abnormal wound response after skin trauma of which the exact etiology is unknown. Ear piercing is one of the most popular body ornamentation that could somehow lead to keloid formation. Objective: To identify any risk factors that may relate to post-ear piercing keloid formation. Materials and Methods: This case control study was conducted in Thai people at Department of Plastic and Maxillofacial Surgery at Ramathibodi Hospital between August 2015 and August 2016. It consisted of post-ear piercing subjects with and without keloid formation as case (43 subjects) and control (44 subjects) groups respectively. Information regarding age at piercing, history of keloid formed, age of keloid formation, site of piercing, method for piercing, jewelry use after piercing, complications, development of keloid at other location of the body, family history of keloid, and skin color was collected. Results: According to the study, complications from piercing such as infection or allergic reaction were signi􀏐icantly related to post-ear piercing keloid formation (p<0.001). Piercing through cartilage was also proven to be one of the major risk factors (p<0.001). There was no difference between cases and controls in terms of age at piercing, method for piercing, use of jewelry, keloid at other location of the body, family history of keloid, and skin color. Conclusion: Two major contributing factors of post-ear piercing keloid formation that were identi􀏐ied from the present study are development of post-piercing complications and cartilage piercing. [ABSTRACT FROM AUTHOR]

Keloids are benign cutaneous lesions, arising from proliferating fibroblasts. Keloids of the ear may occur after trauma, surgery or helix piercings and are difficult to treat, since they tend to form recurrences. Guidelines suggest multimodal therapy; however, recurrence rates remain high and distinct algorithms for the combination of different modalities are missing. To unravel the most effective combination of therapeutic options for keloids of the ear, 38 patients with the diagnosis of an ear keloid were included in our cohort. In a prospective subgroup (B) of this cohort ( n = 17), patients either underwent surgery using the 'fillet technique' (a meticulous peeling of the keloid skin) and intra-lesional injections of triamcinolone 10 mg/ml every 4-6 weeks for 6 months, or they were additionally treated with a non-customized pressure device which was recommended for at least 16/24 h per day over 6 months. To further compare our results, the remaining 21 patients of our cohort, who were treated at our clinic before, were retrospectively evaluated concerning their recurrence rates. The mean follow-up was 48 months. The mean count of adjuvant steroid injections was two in all patients, four in subgroup B. The recurrence rate was 30% (13/38) in all patients (subgroup B 0/17). Aesthetic results were good to excellent in all non-recurrent cases. No patient treated with fillet technique showed recurrence ( p < 0.001). However, we could not confirm a significant effect but a trend of repeated steroid injections for preventing recurrences ( p = 0.099). The application of pressure using our non-customized clip also showed a clear trend towards preventing recurrences in cross-table analysis ( p = 0.057). Although several studies on different treatment regimens for keloids of the ear exist, the effectiveness of a multimodal treatment regimen needs to be elucidated. Overall, the best results in preventing recurrences were achieved by combining three different treatments. However, the fillet technique was the only modality preventing recurrences of keloids in uni- and multivariate analysis. The application of pressure with a non-customized clip and repeated steroid injections also showed a positive trend but failed level of significance. Based on our data and the literature we recommend, when feasible, the combination of more than one therapeutic regimen, since relapse risk went down from single to dual and triple therapy from 40% (8/20) to 14.3% (2/14) to 0% (0/4), respectively in our cohort. The use of 'fillet technique' was especially beneficial. [ABSTRACT FROM AUTHOR]

Background: The reported health and socioeconomic consequences of ear piercing, especially in modern day society, underscore the need to further research into this subject. In this study, we determine the trends and complications of ear piercing among selected Nigerian population. Aim and Objectives: The aim and objective of this study was to draw attention to the trends and complications of ear piercing with a view to prevent its associated complications. Methodology: It is a descriptive cross-sectional study carried out between February and May 2015 among selected Nigerian population from two of its six geo-political zones. A self-administered semi-structured questionnaire which had been pretested was used to collect data from 458 respondents who consented using multistage sampling technique. Results: Of 480 respondents enumerated, 458 completed the questionnaires and gave their biodata. The male:female ratio was 1:6.2. Their ages ranged from 18 to 75 years with a mean of 35.56 ± 10.16. About 35.4% of the respondents were within the age group of 31-40 years. Majority of the respondents, i.e.,79.3% practiced ear piercing on their children. Most of them (86.8%) preferred single piercing. Ear piercing was performed within the 1st week of birth in 37.2% of the respondents. Large percentage (93.2%) of the respondents will not encourage ear piercing in male children. Nearly 20.5% of the respondents observed complications. Conclusion: Ear piercing remained a common practice in Nigeria, with respondents preferring it on females. Majority of the piercings are done in childhood and by untrained personnel. Keloid formation was the notable complication observed by the respondents. There is a need to increase awareness about the hazards of ear piercings and to enact laws that regulate ear piercings particularly in children which is hereby stretched. [ABSTRACT FROM AUTHOR]

Background: The reported health and socioeconomic consequences of ear piercing, especially in modern day society, underscore the need to further research into this subject. In this study, we determine the trends and complications of ear piercing among selected Nigerian population. Aim and Objectives: The aim and objective of this study was to draw attention to the trends and complications of ear piercing with a view to prevent its associated complications. Methodology: It is a descriptive cross-sectional study carried out between February and May 2015 among selected Nigerian population from two of its six geo-political zones. A self-administered semi-structured questionnaire which had been pretested was used to collect data from 458 respondents who consented using multistage sampling technique. Results: Of 480 respondents enumerated, 458 completed the questionnaires and gave their biodata. The male:female ratio was 1:6.2. Their ages ranged from 18 to 75 years with a mean of 35.56 ± 10.16. About 35.4% of the respondents were within the age group of 31-40 years. Majority of the respondents, i.e.,79.3% practiced ear piercing on their children. Most of them (86.8%) preferred single piercing. Ear piercing was performed within the 1st week of birth in 37.2% of the respondents. Large percentage (93.2%) of the respondents will not encourage ear piercing in male children. Nearly 20.5% of the respondents observed complications. Conclusion: Ear piercing remained a common practice in Nigeria, with respondents preferring it on females. Majority of the piercings are done in childhood and by untrained personnel. Keloid formation was the notable complication observed by the respondents. There is a need to increase awareness about the hazards of ear piercings and to enact laws that regulate ear piercings particularly in children which is hereby stretched. [ABSTRACT FROM AUTHOR]

BACKGROUND/OBJECTIVE Management of keloids of the pinna, in particular, those located in the helix and antihelix and lobule that occur as complications of ear piercing. MATERIALS AND METHODS Retrospective analysis of 49 patients treated with extralesional surgical excision of keloids localized to the ear followed by the application of autologous platelet-rich plasma (PRP) to wound site and postoperative in-office superficial radiation therapy (SRT). Radiation protocol consisted of 1 to 3 fractions, with cumulative dosage ranging from 1,300 to 1,800 cGy. Average follow-up was 24 months to assess for evidence of recurrence and adverse side effects. RESULTS Fifty ear keloids were treated with this method, age from 15 to 66 (mean = 32, SD = 16) of which 14 were male and 35 female. Almost 30% (n = 14) of patients acknowledged the source of injury that led to the development of the keloid was ear piercing. Treatment protocol achieved a 94% success rate with 3 patients who reported recurrence. CONCLUSION Surgical excision combined with intraoperative PRP, adjuvant postoperative in-office SRT achieved a 94% nonrecurrence rate on follow-up over a 2-year period. Outcomes provide preliminary, albeit, strong evidence to support this multimodal method as a viable alternative in the management of keloids localized to the ear. [ABSTRACT FROM AUTHOR]

Earlobe keloids are commonly encountered in this era where ear piercing is routine in various traditions. Various medical and surgical methods have been tried for its management. Surgically, fillet flap surgery has better acceptability worldwide. Various difficulties are faced during keloid excision, and we hereby describe few innovative modifications (use of needle, hydrodissection, pressure dressing, bolster button) using cost-effective and simple materials (needles, dynaplast, buttons) to ease the excision of keloids. These have easy adaptability and also reduce the recurrence rate of earlobe keloids. [ABSTRACT FROM AUTHOR]

Background Body piercing has become widespread and is associated with increased complications. Post-piercing chondritis may lead to severe residual deformity. We aimed to report case patients presenting with post-piercing chondritis in our department and to describe clinical features and treatment. Patients and methods We conducted a retrospective study of patients presenting with post-piercing chondritis in the infectious disease department of Tenon Hospital, Paris, France. Results We included 21 patients. Fifteen bacteriological cultures were positive (7 Pseudomonas aeruginosa , 5 Staphylococcus aureus , and three other). Dual intravenous antibiotic therapy was administered to 13 patients for a median duration of six days [2–8], replaced by an oral antibiotic therapy for a median duration of 15 days [7–40]. Eight patients received oral antibiotic monotherapy for 10 days [7–30]. Median duration of antibiotic therapy was 16 days. Earring removal was performed for 18 patients. No ear deformity or general complication was reported. Conclusion Transcartilaginous ear piercing may lead to infectious complications or deformity. In case of chondritis, early administration of an antibiotic therapy active against P . aeruginosa and S . aureus is recommended. Specific guidelines are needed. [ABSTRACT FROM AUTHOR]

Introduction: Lupus vulgaris is the most common form of cutaneous tuberculosis caused by contiguous spread from an underlying infective focus or lymphatic or hematogenous spread. It can also develop at the site of direct inoculation (e.g., tattooing and ear piercing) or Bacillus Calmette-Guerin vaccination. The solitary involvement of the pinna is rare and may face clinicians with a diagnostic dilemma. Herein, we reported the case of a 37-year-old female presenting with lupus vulgaris of the left pinna with a history of ear piercing. Case Report: Our case was a 37-year-old female presenting with asymptomatic erythematous plaques on the left pinna for 2 years. She had a history of ear piercing done 20 years ago. After 6 months of ear piercing, she suffered from recurrent infections at the site of piercing in the left ear, while the other ear was normal. Two years earlier, she developed a small erythematous papule, which slowly progressed in size to the present status. On examination, well-defined erythematous scaly plaques were noted on the left helix. The histopathology of the skin biopsy showed multiple confluent granulomas consisting of the epithelioid cells and lymphocyte with a focal area of necrosis in the dermis. Acid-fast bacilli were not seen in modified Ziehl-Neelsen (ZN) and routine ZN staining. A final diagnosis of lupus vulgaris was made, and the patient was started on antitubercular drugs. There was a significant resolution of the lesion after 2 months of treatment. Conclusion: Cutaneous tuberculosis should be considered in the differential diagnosis of chronic nonhealing granulomatous skin lesions developing at the site of ear piercing. [ABSTRACT FROM AUTHOR]

Background: Lobular keloid appears to be a consequence of hypertrophic inflammation secondary to ear piercings performed under unsterile conditions. We wish to understand the pathogenesis of lobular keloids and report operative outcomes with a literature review. Methods: A retrospective review identified 40 cases of lobular keloids between January, 2005 and December, 2010. Patient records were reviewed for preclinical factors such as presence of inflammation after ear piercing prior to keloid development, surgical management, and histopathologic correlation to recurrence. Results: The operation had been performed by surgical core extirpation or simple excision, postoperative lobular compression, and scar ointments. Perivascular infiltration was noted in intra- and extra-keloid tissue in 70% of patients. The postoperative recurrence rate was 10%, and most of the patients satisfied with treatment outcomes. Conclusion: Histological perivascular inflammation is a prominent feature of lobular keloids. Proper surgical treatment, adjuvant treatments, and persistent follow-up observation were sufficient in maintaining a relatively low rates of recurrence. [ABSTRACT FROM AUTHOR]

Background: Vasovagal reactions are common amongst patients with a fear of needles receiving injections or during venipuncture, but they are rarely studied in healthy people undergoing earlobe piercing. The purpose of this prospective study was to evaluate the incidence and the features of vasovagal reactions observed during earlobe piercing., Methods: Thousand eight hundred and sixty six participants aged older than 13 years had their earlobes pierced in our department from January 2020 to January 2022. When vasovagal reactions occurred during the procedure (e.g., dizziness, pallor, diaphoresis, and faintness, etc.), they were recorded and more detailed demographic information was collected., Results: A total of 196 cases of vasovagal reactions were reported in females amongst 1,866 participants, including 58 who actually lost consciousness during earlobe piercing. The incidence of vasovagal reactions and vasovagal syncope was 10.5 and 3.11% respectively. All syncopal reactions occurred in persons younger than 30 years., Conclusion: Vasovagal syncope is often very sudden and occurs without warning. Practitioners need to be familiar with these reactions, and prevent people from an unpredictable fall and subsequent injury during ear piercing., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Xie, Zhang, Han, Tang, Chen and Liu.)

Suppurative perichondritis of the pinna is a serious condition with potentially long-term cosmetic sequelae. Literature regarding the optimal treatment of these abscesses is scarce with most case series containing low numbers. This work reports the largest series from the UK to date; along with a review of recent literature. A 10-year retrospective review of case notes was undertaken. Demographic data, interventions and microbiology results were recorded along with outpatient descriptions of cosmetic outcomes. 20 patients were identified with male:female ratio of 4:1. Average patient age was 25.3 years (range 8-65). Average duration of symptoms prior to being seen by the ENT department was 9.95 days with an average length of stay in hospital of 2.5 days. 80 % of patients had a surgical intervention performed. The commonest organism grown on microbiological culture was pseudomonas (33 %). Of patients who attended follow-up, 28.6 % had residual deformity. All of these had undergone surgical drainage of the abscess. Residual deformity was associated with longer time before presentation, piercing of the cartilage and a growth of pseudomonas. Prompt surgical management and appropriate antibiotic regimens to cover pseudomonas are the cornerstones of treatment in the event of pinna abscess formation. [ABSTRACT FROM AUTHOR]

Chrysosporium is a large genus of saprophytic fungi that is commonly found in the soil. Infection caused by this organism is rare in humans and typically occurs in immunocompromised patients. Primary cutaneous Chrysosporium infection is relatively rare and has been reported in a heart transplant patient. The prognosis is usually favorable, but very poor in the setting of persistent profound immunosuppression. We herein report a case of primary cutaneous Chrysosporium infection following ear piercing in an immunocompetent patient. It is important for clinicians to consider this condition in patients with slow-onset skin and soft tissue infection following cutaneous injury, even in an immunocompetent setting. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The art of body piercing is ancient; however, nowadays it has evolved into a fashion statement. In the Indian subcontinent, ear and nose piercing hold religious and cultural significance in addition to being done for aesthetic reasons. Body piercing is routinely performed by railroading technique or by piercing guns; many modifications of the technique have emerged. Irrespective of the technique used, the main complications associated are intraoperative bleeding and postoperative infection. To overcome these problems, we describe a novel and simple technique of ear and nose piercing using the radio frequency cautery. [ABSTRACT FROM AUTHOR]

Angiolymphoid hyperplasia with eosinophilia is a rare, benign vascular lesion characterized by discrete, painful papules. Although the exact etiology is unknown, trauma precedes many cases. We present a case of angiolymphoid hyperplasia with eosinophilia in the earlobes of a 15-year-old girl after ear piercing. [ABSTRACT FROM AUTHOR]

A novel staged pull-through technique is offered for the maintenance of the piercing tract during the replacement of a temporary earring (2-0 nylon) to a permanent one following the repair of a split earlobe. This method, which was applied on 28 patients with 30 cleft earlobes, secures the harmless replacement of the temporary earring 6 weeks following the ear lobe repair. No complications such as false root, bleeding, dehiscence or infection were documented during and following the replacement process. The equipment is negligible, inexpensive and readily available. The method requires minimal preparation and causes little if any discomfort to the patient. A follow-up of 6 months did not reveal any widening of the neo-tract or recurrence of the earlobe cleft. Level of Evidence: Level V, therapeutic study. [ABSTRACT FROM AUTHOR]