<![CDATA[Introduction: Psoriasis can affect the external ear, including the auricle, concha, and external auditory canal. This presentation can be difficult to recognize, and clinical evidence remains limited. Objective: This review aimed to summarize the available clinical evidence on external ear psoriasis. Methods: PubMed, Scopus, and Web of Science were searched from inception to July 5, 2026 for original clinical reports, and findings were synthesized narratively. Results: Across the included studies, external ear psoriasis showed a clinical spectrum ranging from pruritic scaly inflammation of the external auditory canal to more advanced disease with edema, otorrhoea or exudative change, granulation-like tissue, canal stenosis or obstruction, impaired tympanic membrane visualization, aural fullness, and conductive hearing symptoms. The available reports also highlighted recurrent diagnostic overlap with seborrheic dermatitis and chronic inflammatory otitis externa. Ear involvement was linked to broader psoriasis burden in some patients, while severe case-based presentations showed that obstructive and hearing-related complications can occur. Treatment evidence was sparse, although improvement was reported after psoriasis-directed local therapy. Overall, the available reports support a phenotype-based approach guided by the degree of inflammation, scale or debris retention, obstruction, hearing symptoms, and the possibility of medicament contact dermatitis in recurrent or refractory cases. Conclusions: External ear psoriasis is a clinically meaningful and likely underrecognized special-site phenotype that should be considered in patients with pruritic, scaly, erythematous canal disease, particularly when psoriasis is present elsewhere. Greater clinical awareness may improve diagnostic attribution and management, while clearer definitions and reporting are needed to strengthen future evidence.]]>
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