Otitis externa in Langerhans' cell histiocytosis - The successful use of topical nitrogen mustard

Otitis externa is a common symptom of Langerhans' cell histiocytosis, and occurs in half of all children with the disease. Previous treatment regima have been either unsuccessful, or associated with undesirable side-effects. This study describes the successful use of topical 20% nitrogen mustard ear drops in the management of five children who had Langerhans' cell histiocytosis with otitis externa. All of them had previously been resistant to other forms of treatment. The children were aged between 6 months and 6 years. The otitis externa free period to date is up to 5 years. Topical nitrogen mustard ear drops are rapidly effective, can be administered at home, have not caused any adverse effects, and are of long-term benefit.