Perioral dermatitis: Difference between revisions
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==Etiology== | ==Background== | ||
===Etiology=== | |||
*Topical or inhaled steroids | *Topical or inhaled steroids | ||
*use of cosmetics, | *use of cosmetics, | ||
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==Clinical Features== | ==Clinical Features== | ||
[[File:ADC 2008 335.jpg]] | |||
* papular, vesiculopapular and papulopustular lesions on erythematous base (Acneiform) | * papular, vesiculopapular and papulopustular lesions on erythematous base (Acneiform) | ||
** confluent aspect, follicular | ** confluent aspect, follicular | ||
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** typically respects rim around and 3-5 mm under lower lip, circular | ** typically respects rim around and 3-5 mm under lower lip, circular | ||
==Differential Diagnosis== | |||
== | |||
*Rosacea | *Rosacea | ||
*Seborrheic Dermatitis | *Seborrheic Dermatitis | ||
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*Granulomatous periorificial dermatitis | *Granulomatous periorificial dermatitis | ||
==Diagnosis== | |||
==Treatment== | ==Treatment== | ||
*Discontinue suspected topicals | *Discontinue suspected topicals | ||
*Rebound reaction | *Rebound reaction | ||
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*Antipruritics containing no corticosteroids | *Antipruritics containing no corticosteroids | ||
==Complications== | |||
*Disfiguring scars - emotional | |||
*Rebound effect, chronic course | |||
*Lupus-like PD - dermal infiltrate, scarring | |||
**Yellowish discoloration after diascopy | |||
== | ==References== | ||
*Ljubojević et al. "Perioral dermatitis" Acta Dermatovenerol Croat. 2008;16(2):96-100 | |||
Ljubojević et al. "Perioral dermatitis" Acta Dermatovenerol Croat. 2008;16(2):96-100 | |||
[[Category:Derm]] | [[Category:Derm]] | ||
Revision as of 14:30, 10 June 2015
Background
Etiology
- Topical or inhaled steroids
- 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.
Prevalence 90% female (increasing in males)
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
Diagnosis
Treatment
- 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
References
- Ljubojević et al. "Perioral dermatitis" Acta Dermatovenerol Croat. 2008;16(2):96-100