Ver el código de «Perioral dermatitis»

==Background==
{{Skin anatomy background images}}
*90% female (increasing in males)

===Etiology===
*[[topical steroids|Topical]] or [[inhaled corticosteroid]]s
*use of cosmetics
*physical (UVB, heat, wind)
*microbiological (fusiform spirilla, [[candida]])
*hormonal factors (premenstrual deterioration, use of oral contraceptives) 
*GI tract abnormalities (malabsorption)
*Emotional stress

{{Dermatitis types}}

==Clinical Features==
[[File:ADC 2008 335.jpg|thumb]]
*papular, vesiculopapular and papulopustular [[rash|lesions]] on erythematous base (Acneiform)
**confluent aspect, follicular
*location perioral, limited to skin
**typically respects rim around and 3-5 mm under lower lip, circular

==Differential Diagnosis==
*Rosacea
*[[Seborrheic dermatitis]]
*Acne vulgaris
*Facial demodicosis
*[[Lupus]] milliaris
*Polymorphous light reaction
*[[Contact dermatitis]]
*Haber syndrome
*Granulomatous periorificial dermatitis

{{DDX oral rashes and lesions}}

==Evaluation==
*Usually clinical

==Management==
*Discontinue suspected topicals
*Rebound reaction
**[[hydrocortisone]] cuts down reaction violence
*[[Corticosteroid]] dependence - psychological follow up
*Suppression of follicular bacterial infection
**Lipophilic [[tetracyclines]] 100-250mg/d for 3-4 months
**no response - Isotretinoin
**Children - oral, topical [[erythromycin]], [[metronidazole]]
*Antipruritics containing no corticosteroids

==Complications==
*Disfiguring scars - emotional
*Rebound effect, chronic course
*Lupus-like PD - dermal infiltrate, scarring
**Yellowish discoloration after diascopy

==See Also==
*[[Rashes]]

==References==
*Ljubojević et al. "Perioral dermatitis" Acta Dermatovenerol Croat. 2008;16(2):96-100

[[Category:Dermatology]]