Perioral dermatitis

Peripheral dermatitis (synovial rosacea-like dermatitis) is considered by some authors to be a separate nosological unit, others consider this dermatosis as a kind of pink acne or seborrhea.

[1], [2], [3], [4], [5]

Causes of perioral dermatitis

The causes and pathogenesis of perioral dermatitis have not been fully established. Importance is attached to the abuse of various cosmetics, fluorine-containing corticosteroid drugs, some additives to toothpaste, increased sensitivity to yeast-like fungi, bacterial infection. Contribute to the development of the disease ovarian dysfunction, adverse meteorological factors.

[6], [7], [8]

Histopathology

There is an expansion of the vessels of the dermis, lymphohistiocyte infiltrates around the vessels and hair follicles.

Pathomorphology

In the skin, there is a moderate pattern of subacute dermatitis with perivascular and perifollicular infiltrates containing a large number of neutrophilic granulocytes. Occasionally, clusters of epithelioid cells are detected with giant forms among them.

The histogenesis of dermatitis is unclear. Some authors attach importance in his development to hypersensitivity to sunlight in persons suffering from seborrhea, the action of fluorine-containing drugs, especially fluorinated corticoteroid ointments.

Symptoms of perioral dermatitis

Periodic dermatitis develops mainly in young women. Eruptions are located around the mouth, on the chin and nasolabial folds, on the cheeks and periorbital less often - in the eyelids, on the cheeks in the form of erythematous spots, flat cone-shaped papules or papulo- vesicles and papulo- pustules. The rash is located symmetrically, consists of many small papules, sometimes papulovezicles, partially acne-like. The red border of the lips is not affected, on the border with the skin there is a light strip of unaffected skin, which is considered characteristic for this dermatosis. The rashes are covered with crusts. Often they are in groups. A characteristic feature is the presence around the mouth of a narrow band, free from rashes. Subjective sensations, as a rule, are insignificant: slight itching, sometimes burning. The course of the disease is long, remissions are usually not prolonged (if the cause of the disease is not eliminated). 

Differential diagnosis

The disease should be distinguished from seborrheic eczema, pink acne.

[9], [10], [11], [12], [13]

Treatment of perioral dermatitis

First, it is necessary to eliminate the cause of the disease. With a mild course of perioral dermatitis, externally ichthyolic, naphthalanic (5-10%), 2-5% sulfuric, 0.5-1% resorcinol paste, 5% dermatol ointment is administered externally. At sharply expressed inflammatory processes, antihistamines (tavegil, fenistil, analegine, etc.), hypo-sensitizing and other drugs, external-corticosteroid (betiovate, elokom, advantan, etc.) and antipruritic (fenistil-gel, dimedrolovaja, anestezinovaja) ointments are applied inside. And other means.