Perioral Dermatitis

Author: Shahnawaz Towheed MS2, Y, Miller-Monthrope, Dermatologist/Dermatopathologist, Toronto, Canada, 2024

Definition: Perioral Dermatitis (i.e., periorificial dermatitis) is an erythematous, papulopustular facial eruption that typically starts around the mouth and can spread to the eyes, nose, and sometimes the forehead. 

Etiology: It primarily affects women of childbearing age and children. The exact cause is unknown, but it has been associated with the use of topical steroids, fluoridated toothpaste, and certain cosmetics. 

Signs/ Symptoms: The condition presents with red, inflamed papules, vesicles, or pustules, and may cause pruritus or a burning sensation. 

Diagnosis: Diagnosis is usually clinical and can be differentiated from similar conditions such as acne and rosacea by the absence of comedones and the typical distribution of lesions. 

Treatment: Treatment involves discontinuing any topical steroids and potentially other facial products that might be aggravating the condition. Additionally, topical agents such as metronidazole, clindamycin, and erythromycin, as well as oral antibiotics such as tetracycline, doxycycline, and minocycline, are commonly used. 

Complications: The prognosis is generally favourable, but PD often recurs and usually take weeks to months to resolve completely​

References:

1.     Lipozenčić J, Hadžavdić, S.L. Perioral dermatitis. Clin Dermatol. 2014;32(1):125–30. doi: 10.1016/j.clindermatol.2013.05.034.

2.     Searle T, Ali FR, Al-Niaimi F. Perioral dermatitis: Diagnosis, proposed etiologies, and management. J Cosmet Dermatol. 2021;20(12):3839–48. doi: 10.1111/jocd.14060.