Papules around mouth and nostrils with some background redness and sparing of vermillion border
Specialty
Dermatology
Symptoms
Papules, pustules, red skin
Complications
Skin infection
Causes
Unknown[1]
Risk factors
Topical steroids, cosmetics, moisturiser
Diagnostic method
Based on symptom and appearance
Differential diagnosis
Rosacea, acne
Treatment
None, tetracycline
Perioral dermatitis, also known as periorificial dermatitis, is a common type of skin rash. Symptoms include multiple small (1–2 mm) bumps and blisters sometimes with background redness and scale, localized to the skin around the mouth and nostrils. Less commonly the eyes and genitalia may be involved.[2] It can be persistent or recurring and resembles particularly rosacea and to some extent acne and allergic dermatitis. The term "dermatitis" is a misnomer because this is not an eczematous process.[3]
The cause is unclear.[1] Topical steroids are associated with the condition and moisturizers and cosmetics may contribute.[3] The underlying mechanism may involve blockage of the skin surface followed by subsequent excessive growth of skin flora. Fluoridated toothpaste and some micro-organisms including Candida may also worsen the condition, but their roles in this condition are unclear.[4] It is considered a disease of the hair follicle with biopsy samples showing microscopic changes around the hair follicle. Diagnosis is based on symptoms.[4]
Treatment is typically by stopping topical steroids, changing cosmetics, and in more severe cases, taking tetracyclines by mouth.[1][5] Stopping steroids may initially worsen the rash. The condition is estimated to affect 0.5-1% of people a year in the developed world. Up to 90% of Those affected are women between the ages of 16 and 45 years, though it also affects children and the elderly, and has an increasing incidence in men.[6][7]
^ abcCite error: The named reference Tem2014 was invoked but never defined (see the help page).
^Goldsmith, Lowell P.; Katz, Stephen I.; Gilchrest, Barbara A.; Paller, Amy S. (2012). "82. Perioral dermatitis". Fitzpatrick's Dermatology in General Medicine (8th ed.). The McGraw-Hill Companies. pp. 926–928. ISBN 978-0-07-166904-7.
^ abDu Vivier, Anthony (2013). Atlas of clinical dermatology (4th ed.). Elsevier Saunders. pp. 609–610. ISBN 9780702034213.
^ abPatterson, James W (2019). "8. The granulomatous reaction pattern". Weedon's Skin Pathology (5th ed.). Elsevier Health Sciences. p. 219. ISBN 978-0-7020-7582-7.
^Cite error: The named reference Hall2010 was invoked but never defined (see the help page).
^Cite error: The named reference :medscape was invoked but never defined (see the help page).
^Habif, Thomas P. (2009). "7. Acne, Rosacea, and Related Disorders". Clinical Dermatology (5th ed.). Mosby, Elsevier. pp. 253–255. ISBN 978-0-7234-3541-9.
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