perioral dermatitis
description
Transcript of perioral dermatitis
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PERIORAL DERMATITIS
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DefinitionA facial dermatosis predominantly affecting females of childbearing years.
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Characterized by an erythematous, micropapular, fine scaling eruption.Affecting the nasolabial folds, chin & upper lip.
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EtiologyUltraviolet light.Infective agents.Demodectic infections.Contact factorsHormonal factors.Glucocorticoids.
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Miscellaneous factors :Initially, all cases were thought associated with seborrheic dermatitis.Problems may be more common in those using the most cosmetics.Emotional stress.
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History of facial eruption affecting the perioral area.The eruption start unilaterally in the nasolabial fold area.Clinical Manifestations
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Extending to involve the chin & upper lip.The classic distribution is of the perioral area but the glabella, eyelids & even forehead may be affected.
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The clinical features are :Erythema usually persistent.Papulosis irregularly grouped, firm, pinhead size erythematous.Scaling usually fine.
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DERMATITIS PERIORAL
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Histologic finding completely different from rosacea :A Mild perivasculer or perifollicular lympho-hystiocytic infiltrate.PathologyTwo fairly large series have been published :
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Mild eczematous change & follicular spongiosis.Presence of eczema & absence of edema, connective tissue disruption & granuloma.
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Histologic finding equated with rosacea :Consistent edema.Perivascular, perifollicular & lymphohistiocytic infiltrate.Vasculitis.
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In the classic case, the clinical picture is so distinctive that there should be no problem with diagnosis.Diagnosis
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TreatmentRarely present a problem & in fact is generally highly successful.
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Systemic :Tetracycline 250 mg (2 x 1) mild 250 mg (4 x 1) severe.Oxytetracycline.Doxycicline.
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Topical :TetracyclineErythromycineClindamycineCombination :Sulfacetamide & hydrocortisoneErythromycine & hydrocortisone