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Weird constellation of symptoms. Thoughts?

NP   (231 Views 3 Comments)
by Pachinko Pachinko (Member)

Pachinko works as a FNP.

7,711 Visitors; 285 Posts

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I have a 60 yo Indian male experiencing chronic itching in his ears, recurrent angular cheilitis, hair loss, eye watering, and scalloped tongue. All of this has developed within the last year.

All B vitamins and thyroid are normal. He is a controlled diabetic without much other history. I stopped his statin for a month but the symptoms are not really resolving.

Sent him to ENT for his ear itching (it was driving him crazy) and they were not much help.

Any thoughts about what might be going on?

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4 Likes; 183 Visitors; 11 Posts

My differential would be the ff:

1. Eczema - possibly refer to allergy/immunology if not managed with treatment of triggers (Allergens, new medications, etc.) Symptoms seem consistent with allergic/chronic inflammation (autoimmune) symptoms.

2. Fungal infection - Consider since he's diabetic. Might explain chronic ear itching and angular cheilitis, but both symptoms can also be seen in an eczematous patient.

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66 Likes; 252 Visitors; 47 Posts

The angular cheilitis can sometimes be caused by yeast infection, which maybe could have spread to his ears causing itching;  Scalloped tongue can be due to sleep apnea, which would be unrelated to the other symptoms.

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