Scribd Logo
Upload

Welcome to Scribd!

  • 36 views

    Who Gets Periorificial Dermatitis

    Uploaded by

    main
    Periorificial dermatitis mainly affects women aged 15-45 and presents as erythematous papules around the mouth, nose, and eyes. It is often associated with the use of topical corticosteroids. While its exact cause is unknown, factors like epidermal barrier dysfunction and altered skin microflora may play a role. Treatment involves discontinuing topical steroids and creams, using topical antibiotics or pimecrolimus, and potentially oral antibiotics for more severe cases. Preventing further occurrences involves avoiding occlusive products and topical steroids on the face when possible.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Who Gets Periorificial Dermatitis

    Uploaded by

    main
    36 views3 pages
    Periorificial dermatitis mainly affects women aged 15-45 and presents as erythematous papules around the mouth, nose, and eyes. It is often associated with the use of topical corticosteroids. While its exact cause is unknown, factors like epidermal barrier dysfunction and altered skin microflora may play a role. Treatment involves discontinuing topical steroids and creams, using topical antibiotics or pimecrolimus, and potentially oral antibiotics for more severe cases. Preventing further occurrences involves avoiding occlusive products and topical steroids on the face when possible.

    Original Description:

    perioral

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Periorificial dermatitis mainly affects women aged 15-45 and presents as erythematous papules around the mouth, nose, and eyes. It is often associated with the use of topical corticosteroids. While its exact cause is unknown, factors like epidermal barrier dysfunction and altered skin microflora may play a role. Treatment involves discontinuing topical steroids and creams, using topical antibiotics or pimecrolimus, and potentially oral antibiotics for more severe cases. Preventing further occurrences involves avoiding occlusive products and topical steroids on the face when possible.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    36 views3 pages

    Who Gets Periorificial Dermatitis

    Uploaded by

    main
    Periorificial dermatitis mainly affects women aged 15-45 and presents as erythematous papules around the mouth, nose, and eyes. It is often associated with the use of topical corticosteroids. While its exact cause is unknown, factors like epidermal barrier dysfunction and altered skin microflora may play a role. Treatment involves discontinuing topical steroids and creams, using topical antibiotics or pimecrolimus, and potentially oral antibiotics for more severe cases. Preventing further occurrences involves avoiding occlusive products and topical steroids on the face when possible.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 3

    Who gets periorificial dermatitis?

    Periorificial dermatitis and its variants mainly affect adult women aged 15 to 45 years. It is
    less common in men. It may affect children of any age.

    People with periorificial dermatitis are often using topical or inhaled corticosteroids.

    What is the cause of periorificial or periorificial


    dermatitis?
    The exact cause of periorificial is not understood. Periorificial dermatitis may be related to:

    Epidermal barrier dysfunction

    Activation of the innate immune system

    Altered cutaneous microflora

    Follicular fusiform bacteria

    Unlike seborrhoeic dermatitis, which can affect similar areas of the face, malassezia yeasts
    are not involved in periorificial dermatitis.

    Periorificial dermatitis may be induced by:

    Topical steroids, whether applied deliberately to facial skin or inadvertently

    Nasal steroids, steroid inhalers, and oral steroids

    Cosmetic creams, make-ups and sunscreens

    Fluorinated toothpaste

    Neglecting to wash the face

    Hormonal changes and/or oral contraceptives

    What are the clinical features of periorificial dermatitis?


    The characteristics of facial periorificial dermatitis are:

    Unilateral or bilateral eruption on chin, upper lip and eyelids in perioral, perinasal and
    periocular distribution

    Sparing of the skin bordering the lips (which then appears pale), eyelids, nostrils
    Clusters of 12 mm erythematous papules or papulopustules

    Dry and flaky skin surface

    Burning irritation

    In contrast to steroid-induced rosacea, periorificial dermatitis spares the cheeks and forehead.

    Genital periorificial dermatitis has a similar clinical appearance. It involves the skin on and
    around labia majora (in females), scrotum (in males) and anus.

    Complications of periorificial dermatitis


    Granulomatous periorificial dermatitis is a variant of periorificial dermatitis that presents
    with persistent yellowish papules. It occurs mainly in young children and nearly always
    follows the use of a corticosteroid. There is a granulomatous perifollicular infiltrate on
    histopathology.

    Steroid rosacea presents with steroid-induced, large facial papules, papulopustules and
    telangiectasia on the mid-face, including forehead and cheeks.

    Rebound flare of severe periorificial dermatitis may occur after abrupt cessation of
    application of potent topical steroid to facial skin.

    How is periorificial dermatitis diagnosed?


    The presentation of periorificial dermatitis is usually typical, so clinical diagnosis is usually
    straightforward. There are no specific tests.

    Skin biopsy shows follicular and perivascular chronic inflammation similar to rosacea.

    What is the treatment for perioral dermatitis?


    Periorificial dermatitis responds well to treatment, although it may take several weeks before
    there is noticeable improvement.

    General measures

    Discontinue applying all face creams including topical steroids, cosmetics and
    sunscreens (zero therapy).

    Consider a slower withdrawal from topical steroid/face creams if there is a severe


    flare after steroid cessation. Temporarily, replace it by a less potent or less occlusive
    cream or apply it less and less frequently until it is no longer required.

    Wash the face with warm water alone while the rash is present. When it has cleared
    up, use a non-soap bar or liquid cleanser if you wish.
    Choose a liquid or gel sunscreen.

    Topical therapy

    Topical therapy is used to treat mild periorificial dermatitis. Choices include:

    Erythromycin

    Clindamycin

    Metronidazole

    Pimecrolimus

    Azelaic acid

    Oral therapy

    In more severe cases, a course of oral antibiotics may be prescribed for 612 weeks.

    Most often, a tetracycline such as doxycycline is recommended. Sub-antimicrobial


    dose may be sufficient.

    Oral erythromycin is used during pregnancy and in pre-pubertal children.

    Oral low-dose isotretinoin may be used if antibiotics are ineffective or


    contraindicated.

    How can periorificial dermatitis be prevented?


    Periorificial dermatitis can generally be prevented by the avoidance of topical steroids and
    occlusive face creams. When topical steroids are necessary to treat an inflammatory facial
    rash, they should be applied accurately to the affected area, no more than once daily in the
    lowest effective potency, and discontinued as soon as the rash responds.

    What is the outlook for periorificial dermatitis?


    Periorificial dermatitis sometimes recurs when the antibiotics are discontinued, or at a later
    date. The same treatment can be used again.

    You might also like