CASE REPORT
A 3-year old male child presented to one of the remote dispensaries with a history of 6-months ulcerative lesions involving the external ear. Lesions were painful and were accompanied by a history of recurrent non-foul smelling ipsilateral otorrhoea. The kid had no history of fever or night sweats, history of trauma involving the external ear or gastrointestinal complaints.
On examination, he was malnourished and the ear had necrotic skin overlying the pinna and multiple papules with some being pus filled.
The patient was subjected to laboratory work ups; Hemoglobin was 13g/dl, HIV negative. Histopathological analysis of the lesions and immunological work ups such as purified protein derivative, venereal disease research laboratory were not done due to remoteness of health facility. Serum albumin and globulin were not ordered because of the same reason despite the child being malnourished. Clinical diagnosis of PG of the external ear was made. (Figure 1 and 2)
The patient received; Intramuscular triamcinolone 40mg stat, prednisolone tablets where 10mg once daily for 7 days was provided and then tapered to 5mg once daily for 7 days, betamethasone cream which was applied topically over the ulcerated external ear, syrup ampicillin+cloxacillin 250mg administered 8-hourly for 7 days and boric acid ear drops were applied 4hourly for 7 days. The patient was followed up for 6-months with no recurrence. (Figure 3)