Perioral dermatitis

Some authors consider perioral dermatitis (syn. rosacea-like dermatitis) to be a separate nosological entity, while others regard this dermatosis as a type of rosacea or seborrheides.

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Causes of Perioral Dermatitis

The causes and pathogenesis of perioral dermatitis have not been fully established. Of great importance are the abuse of various cosmetics, fluorine-containing corticosteroids, some additives to toothpaste, increased sensitivity to yeast-like fungi, and bacterial infections. Ovarian dysfunctions and unfavorable meteorological factors contribute to the development of the disease.

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Histopathology

Dilation of dermal vessels and lymphohistiocytic infiltrates around vessels and hair follicles are noted.

Pathomorphology

The skin shows a moderately expressed picture of subacute dermatitis with perivascular and perifollicular infiltrates containing a large number of neutrophilic granulocytes. Sometimes clusters of epithelioid cells with giant forms among them are detected.

The histogenesis of dermatitis is unclear. Some authors attribute importance to its development to increased sensitivity to sunlight in individuals suffering from seborrhea, and to the action of fluorinated preparations, especially fluorinated corticosteroid ointments.

Symptoms of Perioral Dermatitis

Perioral dermatitis develops mainly in young women. The rash is located around the mouth, on the chin and nasolabial folds, on the cheeks and periorbitally, less often - in the eyelid area, on the cheeks in the form of erythematous spots, flat cone-shaped papules or papulovesicles and papulopustules. The rash is located symmetrically, consists of many small papules, sometimes papulovesicles, partly acne-like. The red border of the lips is not affected, a light strip of unaffected skin remains on its border with the skin, which is considered characteristic of this dermatosis. The rash is covered with crusts. They are often located in groups. A characteristic sign is the presence of a narrow strip around the mouth, free of rashes. Subjective sensations are usually insignificant: mild itching, sometimes burning. The course of the disease is long, remissions are usually short-lived (if the cause of the disease is not eliminated).

Differential diagnosis

The disease should be distinguished from seborrheic eczema and rosacea.

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Treatment of perioral dermatitis

First, it is necessary to eliminate the cause of the disease. In case of mild perioral dermatitis, ichthyol, naphthalan (5-10%), 2-5% sulfur, 0.5-1% resorcinol pastes, 5% dermatol ointment are prescribed externally. In case of severe inflammatory processes, antihistamines (tavegil, fenistil, analergin, etc.), hyposensitizing and other drugs are used internally, and corticosteroids (betiovate, elokom, advantan, etc.) and antipruritic (fenistil gel, diphenhydramine, anesthesin) ointments and other agents are used externally.