Perioral dermatitis: Difference between revisions

(Text replacement - "==Diagnosis==" to "==Evaluation==")
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==Etiology==
==Background==
*90% female (increasing in males)


===Etiology===
*Topical or inhaled steroids
*Topical or inhaled steroids
*use of cosmetics,
*use of cosmetics,
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*GI tract abnormalities (malabsorption)
*GI tract abnormalities (malabsorption)
*emotional stress.
*emotional stress.
Prevalence 90% female (increasing in males)


==Clinical Features==
==Clinical Features==
[[File:ADC 2008 335.jpg|thumb]]
*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


* papular, vesiculopapular and papulopustular lesions on erythematous base (Acneiform)
==Differential Diagnosis==
** confluent aspect, follicular
* location perioral, limited to skin
** typically respects rim around and 3-5 mm under lower lip, circular
 
[[File:ADC 2008 335.jpg]]
 
==Complications==
 
*Disfiguring scars - emotional
*Rebound effect, chronic course
*Lupus-like PD - dermal infiltrate, scarring
**Yellowish discoloration after diascopy
 
==DDX==
 
*Rosacea
*Rosacea
*Seborrheic Dermatitis
*Seborrheic Dermatitis
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*Granulomatous periorificial dermatitis
*Granulomatous periorificial dermatitis


{{DDX oral rashes and lesions}}


==Treatment==
==Evaluation==
*Usually clinical


==Management==
*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


==Source==
==See Also==
 
*[[Rashes]]
Ljubojević et al. "Perioral dermatitis" Acta Dermatovenerol Croat. 2008;16(2):96-100


==References==
*Ljubojević et al. "Perioral dermatitis" Acta Dermatovenerol Croat. 2008;16(2):96-100


[[Category:Derm]]
[[Category:Dermatology]]

Revision as of 12:56, 26 July 2016

Background

  • 90% female (increasing in males)

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.

Clinical Features

ADC 2008 335.jpg
  • 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

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