Maryam Ghasemi Daneshjooye Pezeshki Daneshgah Esfahan DR Fatemi

Perioral dermatitis

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

etiology no convincing explanation no convincing explanation Candida Candida Fusiform bacteria Fusiform bacteria Demodex mite Demodex mite Cosmetics Cosmetics Fluoride-containing toothpaste Fluoride-containing toothpaste potent topical corticosteroids, particularly fluorinated topical corticosteroids 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 first appears around the external nares and the superior end of the nasolabial folds or around the lip commissures spreads around the mouth spreads around the mouth leaving a clear and uninvolved zone immediately adjacent to the lips leaving a clear and uninvolved zone immediately adjacent to the lips If severe and/or long-standing (side of nose & glabella) If severe and/or long-standing (side of nose & glabella)

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

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

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

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