Perioral dermatitis

Perioral dermatitis
Perioral dematitis in a young male with a history of licking his lips
Classification and external resources
Specialty dermatology
ICD-10 L71.0
ICD-9-CM 695.3
DiseasesDB 31371
MedlinePlus 001455
eMedicine derm/321
MeSH D019557

Perioral dermatitis (also called periorificial dermatitis) is skin disease characterised by multiple small (1–2 mm) papules, pustules and vesicles which are localized to the skin around the mouth, around the nostrils, or around the eyes. It most commonly affects women between the ages of 20 and 45 years, but may also affect children, men and the elderly. It is estimated to affect 0.5-1% of people a year in the developed world.[1]

Signs and symptoms

Perioral dermatitis in a child who had a habit of licking their lips

Perioral dermatitis may be asymptomatic or may be associated with a burning, stinging sensation in the affected areas.

When periorbital dermatitis is found in otherwise healthy prepubertal children, with a profusion of grouped papules on the perioral, periocular, and perinasal areas, the condition is referred to as Granulomatous perioral dermatitis.[2]

Causes

The cause of perioral dermatitis is unknown.[3] It often happens after the use of topical steroid on the face.[3]

There are many potential causes of perioral dermatitis including chewing gum, certain medications, hormone changes, and autoimmune diseases.[3] Lip licking, lip chewing, sucking, and allergies to ingredients in certain dental products have also been reported as causes.[4] Balsam of Peru and cinnamic aldehyde (both often used as flavoring in food, lipstick, mouthwash, and toothpaste), rosin in some chewing gum, cinnamon, and peppermint are other potential allergens that may cause perioral dermatitis.[5]

Diagnosis

A diagnosis of perioral dermatitis is typically made based on the characteristics of the rash. A skin biopsy is usually not required to make the diagnosis but can be helpful to rule out other skin diseases which may resemble perioral dermatitis.

Other skin diseases which may resemble perioral dermatitis include:

Treatment

Perioral dermatitis will usually resolve within a few months without medication. Topical corticosteroids should be stopped entirely if possible.[6]

A number of medications speed up recovery including: tetracycline, doxycycline, and erythromycin.[7] Erythromycin may be used as a cream.[6] Metronidazole does not appear to be as good as tetracycline.[6]

See also

References

  1. http://emedicine.medscape.com/article/1071128-overview#a6
  2. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 250. ISBN 0-7216-2921-0.
  3. 1 2 3 Tempark, T; Shwayder, TA (Apr 2014). "Perioral dermatitis: a review of the condition with special attention to treatment options.". American journal of clinical dermatology. 15 (2): 101–13. PMID 24623018. doi:10.1007/s40257-014-0067-7.
  4. Pudupakkam K. Vedanthan; Harold S. Nelson; Shripad N. Agashe; Mahesh P A; Rohit Katial (2014). Textbook of Allergy for the Clinician. CRC Press. Retrieved May 1, 2014.
  5. Jennifer Cafardi (2012). The Manual of Dermatology. Springer. Retrieved May 1, 2014.
  6. 1 2 3 Hall, CS; Reichenberg, J (August 2010). "Evidence based review of perioral dermatitis therapy.". Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia. 145 (4): 433–44. PMID 20823788.
  7. U.S. National Library of Medicine (December 11, 2009) 'Perioral dermatitis'. Retrieved August 7, 2010.
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