Perioral dermatitis is an eruption of inflammatory papules (and sometimes pustules) on the chin, perioral areas, and nasolabial folds, characteristically sparing the skin immediately adjacent to the vermilion border. It is usually seen in young women, but also accurs in childhood. The development of perioral dermatitis is frequently preceded by intentional or inadvertent application of potent topical corticosteroids to the facial skin. A similar eruption involving the eyelids and periorbital skin has been termed periocular dermatitis. The granulomatous subset of perioral dermatitis, which is histologically confirmed presents with small flesh-colored or yellow-brown papules.
The suggested relationship of perioral dermatitis with infectious agents and infestations such as candida spp. or Demodex folliculorum has not been confirmed.
Although sometimes described as a variant of rosacea, perioral dermatitis is distinguished from this disease by its distribution, by the relatively monomorphic appearance of the lesions, by the absence of flushing and telangiectasia, and by its tendency to occur in younger patients.
Specific Investigations
- No investigation is routinely required
First- Line Therapy
- Withdrawal of topical corticoids
Oral teracyclines
Second- Line Therapy
- Topical pimecrolimus
- Topical teracyclines
- Topical erythromycin
- Oral erythromycin
- Topical metronidazole
- Topical azelaic acid
- Oral isotretinoin
- Topical adapalene
- Photodynamic therapy