Perioral dermatitis: Difference between revisions
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==Background== | ==Background== | ||
{{Skin anatomy background images}} | |||
*90% female (increasing in males) | *90% female (increasing in males) | ||
===Etiology=== | ===Etiology=== | ||
*[[topical steroids|Topical]] or [[inhaled corticosteroid]]s | *[[topical steroids|Topical]] or [[inhaled corticosteroid]]s | ||
*use of cosmetics | *use of cosmetics | ||
*physical (UVB, heat, wind) | *physical (UVB, heat, wind) | ||
*microbiological (fusiform spirilla, [[candida]]) | *microbiological (fusiform spirilla, [[candida]]) | ||
*hormonal factors (premenstrual deterioration, use of oral contraceptives) | *hormonal factors (premenstrual deterioration, use of oral contraceptives) | ||
*GI tract abnormalities (malabsorption) | *GI tract abnormalities (malabsorption) | ||
* | *Emotional stress | ||
{{Dermatitis types}} | |||
==Clinical Features== | ==Clinical Features== | ||
Latest revision as of 17:28, 11 December 2024
Background
- 90% female (increasing in males)
Etiology
- Topical or inhaled corticosteroids
- use of cosmetics
- physical (UVB, heat, wind)
- microbiological (fusiform spirilla, candida)
- hormonal factors (premenstrual deterioration, use of oral contraceptives)
- GI tract abnormalities (malabsorption)
- Emotional stress
Dermatitis Types
- Atopic dermatitis
- Candida dermatitis
- Cercarial dermatitis
- Contact dermatitis
- Dermatitis herpetiformis
- Diaper dermatitis
- Dyshidrotic dermatitis
- Neonatal seborrhoeic dermatitis
- Nummular dermatitis
- Perianal streptococcal dermatitis
- Perioral dermatitis
- Seborrheic dermatitis
- Stasis dermatitis
Clinical Features
- papular, vesiculopapular and papulopustular lesions on erythematous base (Acneiform)
- confluent aspect, follicular
- location perioral, limited to skin
- typically respects rim around and 3-5 mm under lower lip, circular
Differential Diagnosis
- Rosacea
- Seborrheic dermatitis
- Acne vulgaris
- Facial demodicosis
- Lupus milliaris
- Polymorphous light reaction
- Contact dermatitis
- Haber syndrome
- Granulomatous periorificial dermatitis
Oral rashes and lesions
- Angioedema
- Aphthous stomatitis
- Herpes gingivostomatitis
- Herpes labialis
- Measles (Koplik's spots)
- Perioral dermatitis
- Oral thrush
- Steven Johnson syndrome
- Streptococcal pharyngitis
- Tongue diagnoses
- Vincent's angina
Evaluation
- Usually clinical
Management
- Discontinue suspected topicals
- Rebound reaction
- hydrocortisone cuts down reaction violence
- Corticosteroid dependence - psychological follow up
- Suppression of follicular bacterial infection
- Lipophilic tetracyclines 100-250mg/d for 3-4 months
- no response - Isotretinoin
- Children - oral, topical erythromycin, metronidazole
- Antipruritics containing no corticosteroids
Complications
- Disfiguring scars - emotional
- Rebound effect, chronic course
- Lupus-like PD - dermal infiltrate, scarring
- Yellowish discoloration after diascopy
See Also
References
- Ljubojević et al. "Perioral dermatitis" Acta Dermatovenerol Croat. 2008;16(2):96-100