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At least 37 records · Page 2Linked to original sources
PubMed1997

Perioral dermatitis in children--clinical presentation, pathogenesis-related factors and response to topical metronidazole.

BACKGROUND: Perioral dermatitis, a common skin disorder in young women, is rarely described in children. OBJECTIVE: This study elaborates the clinical features of perioral dermatitis in children as well as possible pathogenetic mechanisms and the response to topical metronidazole. METHODS: Seven children (4 females, 3 males between 4 and 12 years of age) were evaluated and dermatological examination was carried out. Pretreatment with topical corticosteroids was documented. Skin prick test with a panel of six common aeroallergens was performed in all children. All children were screened for gastrointestinal colonization with Candida albicans. Patients were treated with topical metronidazole 1% during the first 2 weeks. From the 3rd week on 2% metronidazole was used. RESULTS: In all but one child topical corticosteroids had been used in the face prior to the first presentation at our outpatient department suggesting a possible pathogenetic role. An association with atopy or intestinal candida colonization was not found. In all children skin lesions resolved after 3-6 months. The children remained free of symptoms over an observation period of 2 years. CONCLUSION: Perioral dermatitis has to be considered as differential diagnosis in children presenting with erythematous papules and papulovesicles in typical locations. Metronidazole proved to be effective and safe in the treatment of perioral dermatitis in children. Atopy and gastrointestinal colonization with C. albicans do not seem to play a role in the pathogenesis of perioral dermatitis.

Administration, Topical↗
PubMed1979

Perioral dermatitis: a 12-year review.

A continuing study of perioral dermatitis over a period of 12 years is presented. A distinction is made between various patterns of circumoral and paranasal dermatitis and the clinical picture that we describe as "perioral dermatitis". No cases were seen before 1966 but the number of patients presenting to hospital clinics or in private practice rose dramatically until 1970-1972, after which there has been a progressive fall in numbers. In this period, 259 patients were diagnosed as having the condition and of these 203, resident in an area of some 275,000 population and seen by one or other of us on at least two occasions, form the basis of this study. There were 173 females, fifteen males and fifteen children under 12 years of age. In many cases it was possible to suggest the primary lesion for which patients sought treatment. In sixty-nine patients this consisted of a para-oral eruption on the side of the chin and, in forty-one a paranasal erythematous dermatitis. The characteristic appearance and spread of the eruption to the glabella and eyelids are described. A few patients, mostly male, showed lesions around the eyelids only, from treatment of seborrhoeic dermatitis. All but nine of the patients acknowledged the use of potent (not necessarily fluorinated) topical corticosteroids over long periods; in many cases these were self-administered. Some of the children had been treated with preparations intended for their mothers. The numerous aetiological agents that have been incriminated as causes of this eruption are examined. We believe that the prolonged use of topical potent corticosteroids is the only one tenable from our observations. The role of hormonal factors and of local irritant agetns is examined in this context. Tetracyclines are curative in the great majority of patients in 6 weeks if local corticosteroids are discarded. Relapses are rare. Perioral dermatitis is a most satisfying condition to treat but several questions remain unanswered. The current "revolt" against all forms of cortisone may enable us to answer some of these in the near future.

Administration, Topical↗
PubMed1978

[Perioral dermatitis].

The cause of perioral dermatitis remains unclear. It is not due to the application of fluorinated corticosteroids. For therapy Locoid cream and tetracycline are recommended. There are some cases which are not influenced by any therapy. In these cases psychotherapy is sometimes effective.

Facial Dermatoses↗
PubMed1981

[Histopathologic study of perioral dermatitis].

38 biopsies of perioral dermatitis have been examined. The following has consistently been observed: follicular hyperkeratosis; vasodilatation and oedema (sometimes very pronounced) of the papillary dermis; perivascular and parafollicular infiltrates consisting predominantly of lymphocytes, histiocytes and polymorphonuclear leucocytes. Occasionally, there have been epithelioid or giant cells, sarcoid-like infiltrates or vasculitis of the leucoclastic type. Demodex folliculorum was observed in only two sections and the follicles that contained them were not inflamed. This histological picture is very similar to that of acne rosacea.

Adult↗
PubMedDate not supplied

[Statistical studies and results of treatment of patients with perioral dermatitis].

279 patients suffering from perioral rosaceiform dermatitis have been treated during the past 5 years. With the exception of two men and one five-year-old girl, all patients were female adults, mostly in their thirties. Skin eruptions had been present for 1--2 years in 73% of the cases. Two third of the patients had been treated locally with corticosteroids and one tenth of this group had previously undergone systemic therapy. In 22,2% of the patients, typical signs of local corticosteroid overtreatment were seen. There was a great number of patients holding rather high-ranking jobs and showing remarkable zeal to advance either in their habitual professional field or in a new career. 90% of the perioral dermatitis patients suffered from concomitant vegetative disturbances, especially nervousness, insomnia, headaches and fatigue. In 40% of the cases, symptoms of general neurovascular lability were stated and 60% complained of digestive troubles, particularly obstipation. Out of 220 patients, 206 (=93%) supervised since the end of our treatment showed no relapse of their dermatosis. Our therapeutic program since 1970 consists of mild, corti-costeroid-free local treatment and psychotherapy (see A. Thurn). In the majority of cases, the skin lesions disappeared during the first 3 months and in 90% after 6 months. In 33 cases, under conditions of stress and conflict, one or several relapses occured before final recovery was attained. The evaluation of therapy results showed a progredient reduction of recovery time corresponding to the increasing psychoanalytical experience of our interdisciplinary team. However, in perioral dermatitis patients showing no concomitant vegetative symptoms (10%), a conspiciously longer recovery time was noted, when compared with the remainder of our cases. Patients suffering from several concomitant vegetative symptoms may possibly stop, taking out' psychic problems on their skin when partially resolved by short-term therapy, tending instead to ,somatize' their conflicts in other susceptible organs.

Adrenal Cortex Hormones↗
PubMed1977

[Etiology of perioral dermatitis].

The studies of Röckl und Schubert supported the theory that fusobacteria are often found in perioral dermatitis. When we characterize perioral dermatitis as fusobacteriosis, we do not have any doubt that fluorinated corticosteroids represent a very important pathogenetic factor. Corticoids enable opportune fusobacteria to become pathogenic. In our opinion without these bacteria the beginning of the perioral dermatitis seems impossible. Other supporting causes, which are relevant to sex distribution (oral contraceptives, moisturizing creams) are described.

Contraceptives, Oral↗
PubMedDate not supplied

[Psychological findings in a group of patients with perioral dermatitis].

Female patients suffering from perioral dermatitis were given the Raven Test, two personality inventories (MMPI and FPI) and the Rorschach Test. The results of these four tests show statistically significant differences from controls, indicating emotional immaturity combined with high intelligence level, inability to achieve satisfactory interpersonal relationships contrasting with an overemphasis upon social conformity, and a tendency to 'hysteriform' reactions.

Dermatitis↗
PubMed2005

Critical appraisal of reports on the treatment of perioral dermatitis.

BACKGROUND: Presently, problems exist with the rationale of oral therapy and the nature and indication of topical and accompanying treatment of perioral dermatitis. OBJECTIVE: Providing the basis to overcome these problems by a quality evaluation of treatment reports and assessment of the consistency of treatment experience. METHODS: Sources were Medline (1964-2004), Embase (1966-2004), the Cochrane Central (1971-2004) and 526 references of 3 textbooks, 2 recent reviews and 30 papers on perioral dermatitis. Thirty English and German articles were selected. These studies were evaluated according to principles of evidence-based medicine and related criteria. Evaluation of 28 papers was carried out by the authors and of our own 2 papers by 2 other reviewers. Consistency of results was qualitatively assessed by the authors. RESULTS: There were only 2 therapeutic trials of medium-range quality. The other studies were of low quality. Consistency was noted concerning treatment with oral tetracycline (with 1 exception), discontinuation of topical corticosteroids and cosmetics and, to a lesser extent, regarding no therapy. There was inconsistency in respect to topical therapy. CONCLUSION: The presented data help to interpret and conduct studies on the treatment of perioral dermatitis.

Administration, Oral↗
PubMed1976

Perioral dermatitis: etiology and treatment.

Ninety-five patients with perioral dermatitis were studied from an epidemiological aspect. Consistent clearing of the eruption was obtained with oral tetracycline in combination with a topical sodium sulfacetamide-sulfur-hydro-cortisone lotion. Comparison of the study group of patients to a group of 50 control patients revealed highly significant quantitative differences in the cosmetic preparations used by the two groups. This latter finding would suggest that lubricating and moisturizing products play some part in the etiology of perioral dermatitis.

Administration, Topical↗
PubMed1997

[Perioral dermatitis in children under steroid inhalation therapy].

Topically applied corticosteroid is a known provoking factor in perioral dermatitis. In recent years inhaled corticosteroids have become first line therapy for asthma in children. We present two characteristic cases of perioral dermatitis that developed during asthma treatment with budesonide using either a nebulizer or a spacer connected with a mask. In severe cases treatment with oral erythromycin or topical metronidazole gel may be considered. The eruption should not be confused with atopic eczema.

Administration, Inhalation↗