Maryam GhasemiMaryam GhasemiDaneshjooye Pezeshki Daneshjooye Pezeshki

Daneshgah Daneshgah EsfahanEsfahan

901111521901111521DR FatemiDR Fatemi

Perioral Perioral dermatitisdermatitis

DEFINITIONDEFINITION • young women (15-25 years)young women (15-25 years)

• facial skin around the mouthfacial skin around the mouth

• inflammatory disorder with inflammatory disorder with small papules and pustules small papules and pustules

•Relatively common Relatively common

etiologyetiology no convincing explanation no convincing explanation CandidaCandida Fusiform bacteriaFusiform bacteria Demodex miteDemodex mite CosmeticsCosmetics Fluoride-containing toothpaste Fluoride-containing toothpaste potent topical corticosteroids, particularly potent topical corticosteroids, particularly fluorinated topical corticosteroids fluorinated topical corticosteroids

Clinical featuresClinical featuresfirst appears around the external nares first appears around the external nares and the superior end of the nasolabial folds and the superior end of the nasolabial folds or around the lip commissures or around the lip commissures

spreads around the mouthspreads around the mouth

leaving a clear and uninvolved zone leaving a clear and uninvolved zone immediately adjacent to the lips immediately adjacent to the lips

If severe and/or long-standing (side of If severe and/or long-standing (side of nose & glabella)nose & glabella)

Clinical featuresClinical featuresPeriocular perioral dermatitis ( if Periocular perioral dermatitis ( if predominantly around the eyespredominantly around the eyes ) )

Type of lesions:typically small papules (or Type of lesions:typically small papules (or micropapules), sometimes pustules micropapules), sometimes pustules

No persistent erythema or telangiectasiaNo persistent erythema or telangiectasia

little in the way of symptoms apart from little in the way of symptoms apart from some mild sorenesssome mild soreness

DDxDDxrosacearosacea : :1-facial convexities1-facial convexities 2-persistant erythema2-persistant erythema 3-telangiectasia 3-telangiectasia Seborrheic dermatitis:1-scalingSeborrheic dermatitis:1-scaling 2-scalp dandruf2-scalp dandruf 3-other area of body3-other area of bodyAcne:1-locationAcne:1-location 2-comedons2-comedons 3-seborrhea3-seborrhea 4-upper trunk4-upper trunk

DDxDDxlip-licking cheilitis : :1-(7-15 years old)1-(7-15 years old)

2-repeated licking of 2-repeated licking of the the

Skin around the mouthSkin around the mouth

3-scaling 3-scaling

treatmenttreatmentAll topical steroids should be stoppedAll topical steroids should be stopped

Oral Tetracycline & its familyOral Tetracycline & its family

Oral erythromycinOral erythromycin

Topical antibiotics (metronidazole, Topical antibiotics (metronidazole, erythromycine,tetracycline) erythromycine,tetracycline)