Perioral dermatitis: Difference between revisions
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== | ==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. | ||
==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 | |||
==Differential Diagnosis== | |||
== | |||
*Rosacea | *Rosacea | ||
*Seborrheic Dermatitis | *Seborrheic Dermatitis | ||
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*Granulomatous periorificial dermatitis | *Granulomatous periorificial dermatitis | ||
{{DDX oral rashes and lesions}} | |||
== | ==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 | |||
== | ==See Also== | ||
*[[Rashes]] | |||
==References== | |||
*Ljubojević et al. "Perioral dermatitis" Acta Dermatovenerol Croat. 2008;16(2):96-100 | |||
[[Category: | [[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
- 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