Post on 05-Mar-2016
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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