perioral dermatitis

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perioral dermatitis

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  • PERIORAL DERMATITIS

  • DefinitionA facial dermatosis predominantly affecting females of childbearing years.

  • Characterized by an erythematous, micropapular, fine scaling eruption.Affecting the nasolabial folds, chin & upper lip.

  • EtiologyUltraviolet light.Infective agents.Demodectic infections.Contact factorsHormonal factors.Glucocorticoids.

  • Miscellaneous factors :Initially, all cases were thought associated with seborrheic dermatitis.Problems may be more common in those using the most cosmetics.Emotional stress.

  • History of facial eruption affecting the perioral area.The eruption start unilaterally in the nasolabial fold area.Clinical Manifestations

  • Extending to involve the chin & upper lip.The classic distribution is of the perioral area but the glabella, eyelids & even forehead may be affected.

  • The clinical features are :Erythema usually persistent.Papulosis irregularly grouped, firm, pinhead size erythematous.Scaling usually fine.

  • DERMATITIS PERIORAL

  • Histologic finding completely different from rosacea :A Mild perivasculer or perifollicular lympho-hystiocytic infiltrate.PathologyTwo fairly large series have been published :

  • Mild eczematous change & follicular spongiosis.Presence of eczema & absence of edema, connective tissue disruption & granuloma.

  • Histologic finding equated with rosacea :Consistent edema.Perivascular, perifollicular & lymphohistiocytic infiltrate.Vasculitis.

  • In the classic case, the clinical picture is so distinctive that there should be no problem with diagnosis.Diagnosis

  • TreatmentRarely present a problem & in fact is generally highly successful.

  • Systemic :Tetracycline 250 mg (2 x 1) mild 250 mg (4 x 1) severe.Oxytetracycline.Doxycicline.

  • Topical :TetracyclineErythromycineClindamycineCombination :Sulfacetamide & hydrocortisoneErythromycine & hydrocortisone