What does the 'wet newspaper' appearance in otitis externa indicate?

In the context of otitis externa, the 'wet newspaper' appearance refers to a specific clinical observation associated with fungal infections, particularly those caused by organisms such as Aspergillus. This appearance is characterized by the presence of moist, flimsy debris in the ear canal that resembles the texture of a wet newspaper.

Fungal otitis externa often manifests with intense itching, redness, and a discomforting feeling within the ear. Unlike bacterial infections, which typically present with purulent discharge and possibly associated fever, fungal infections tend to have a more chronic course and can be accompanied by a more subtle, less intense discharge. The presence of the 'wet newspaper' appearance suggests an accumulation of fungal hyphae and spores, which contributes to its characteristic texture and color.

Recognizing this feature is essential for accurate diagnosis and management, as treatment for fungal otitis externa differs significantly from that for bacterial or allergic causes of ear inflammation. Therefore, identifying the specific appearance assists clinicians not only in confirming a fungal etiology but also in guiding appropriate antifungal treatment strategies.