Maryam Ghasemi Daneshjooye Pezeshki Daneshgah Esfahan 901111521 DR Fatemi

Perioral dermatitis

DEFINITION young women (15-25 years) facial skin around the mouth inflammatory disorder with small papules and pustules Relatively common

etiology no convincing explanation Candida Fusiform bacteria Demodex mite Cosmetics Fluoride-containing toothpaste potent topical corticosteroids, particularly fluorinated topical corticosteroids

Clinical features first appears around the external nares and the superior end of the nasolabial folds or around the lip commissures spreads around the mouth leaving a clear and uninvolved zone immediately adjacent to the lips If severe and/or long-standing (side of nose & glabella)

Clinical features Periocular perioral dermatitis ( if predominantly around the eyes ) Type of lesions:typically small papules (or micropapules), sometimes pustules No persistent erythema or telangiectasia little in the way of symptoms apart from some mild soreness

DDx rosacea :1-facial convexities 2-persistant erythema 3-telangiectasia Seborrheic dermatitis:1-scaling 2-scalp dandruf 3-other area of body Acne:1-location 2-comedons 3-seborrhea 4-upper trunk

DDx lip-licking cheilitis :1-(7-15 years old) 2-repeated licking of the Skin around the mouth 3-scaling

treatment All topical steroids should be stopped Oral Tetracycline & its family Oral erythromycin Topical antibiotics (metronidazole, erythromycine,tetracycline)