The diagnosis of ANY skin disease is based on detailed history taking, clinical findings (identification of primary lesions, distribution of lesions), laboratory testing and therapeutic trials. For autoimmune skin diseases (AISD) the most beneficial laboratory procedure is histopathologic evaluation.
It is important to understand that ear disease is only a symptom (no more specific than “pruritus”). As Dr Flemming Kristensen stated “ A patient showing ear problems is a dermatology case until proven otherwise”. It is appropriate therefore to approach the diagnosis of ear disease just as you would for any other skin disease.