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At least 19 recordsLinked to original sources
PubMed2000

Topical applications and perioral dermatitis.

Perioral dermatitis (POD) is a common dermatosis and is considered by most dermatologists to be increasing in incidence. An Australia-wide, questionnaire-based study investigating the aetiology of POD was conducted, with particular emphasis on the significance of cosmetic use. One hundred and thirty-three cases were obtained from dermatologists across Australia and were compared with 99 randomly selected controls who were matched for age and sex. Application of foundation, in addition to moisturizer and night cream resulted in a 13-fold increased risk for POD (odds ratio 13.5; P < 0.001). The combination of moisturizer and foundation was associated with a lesser but significantly increased risk for POD (odds ratio 2.9; P = 0.017). Moisturizer alone was not associated with an increased risk of POD. These findings suggest that cosmetic preparations play a vital role in the aetiology of POD, perhaps by an occlusive mechanism. In 83% of cases, topical steroid application to the face occurred after the development of a facial rash.

Adolescent↗
PubMed1984

Perioral dermatitis.

Perioral dermatitis is an eruption that has a characteristic perioral localization. It usually responds rapidly to systemic tetracycline and low-potency topical corticosteroids. In a study of eighty-seven patients it was found that systemic erythromycin is also effective and that in some instances topical antibiotics combined with 1 per cent hydrocortisone may be effective.

Administration, Oral↗
PubMed1999

Perioral dermatitis in children.

Perioral dermatitis is a unique skin disorder of childhood. Its exact origin is unknown; it is probably an idiosyncratic response to exogenous factors such as the use of a topical fluorinated corticosteroid or other substances on the face. It is uncommon but not rare. The age of affected children has ranged from 7 months to 13 years, with the median being in the prepubertal period. Boys and girls, blacks and whites are equally affected. Clinical features include the following: (1) absence of systemic symptoms; (2) periorificial distribution (perioral, perinasal, periorbital); (3) skin lesions that consist of flesh colored or erythematous inflammed papules, micronodules, and rare pustules; and (4) variable pruritus. Laboratory tests are negative. Histologically, it is indistinguishable from rosacea; there is a superficial perifollicular granuloma consisting of epitheliod cells, and lymphohistiocytic infiltrate, with occasional giant cells. The disease waxes and wanes for weeks and months. Treatment consists of discontinuing topical fluorinated corticosteroid use if any, and using topical metronidazole alone or in combination with either oral tetracycline or erythromycin depending on the child's age. A low-potency topical steroid may also be used to suppress the inflammation and to wean off the strong steroid. Perioral dermatitis in childhood is probably a juvenile form of rosacea.

Administration, Topical↗
PubMed1993

Topical corticosteroid 'addiction'. A cause of perioral dermatitis.

Acne rosacea, perioral dermatitis, and telangiectasia are all local side effects that can flare up when potent topical corticosteroids used on the face are withdrawn. The two cases of perioral dermatitis described here illustrate the nature of the addictive cycle caused by long-term use of these agents. To prevent side effects of topical corticosteroids used on the face, physicians need to avoid long-term prescriptions and shun superpotent agents entirely for this area. Pharmacists should not refill topical corticosteroid prescriptions without authorization. Patient education must emphasize the transient nature of flare-ups of itching and rash that occur when these agents are withdrawn. Systemic and topical antibiotics and corticosteroid-free antipruritics are the mainstays of therapy.

Administration, Topical↗
PubMed1992

Perioral dermatitis in childhood.

BACKGROUND: Although perioral dermatitis has been well described in young women, little has been reported about this condition in children. OBJECTIVE: The purpose of this study was to define more clearly the features of perioral dermatitis in childhood. METHODS: Fourteen children with perioral dermatitis were assessed for clinical features, therapeutic response, and possible etiologic factors. RESULTS: Fourteen cases of perioral dermatitis were seen in 16 months, far exceeding the expected prevalence in childhood. Although the childhood variant shares many characteristics with the adult form, children often have periocular and perinasal lesions, as well as a higher relative incidence in boys. Mid- to high-potency topical corticosteroids were used in seven of the patients (50%) and likely contributed to the pathogenesis. All children responded rapidly to treatment. CONCLUSION: Perioral dermatitis in childhood, often iatrogenic, is more common than previously reported.

Administration, Cutaneous↗
PubMed1983

Topical therapy for perioral dermatitis.

Six patients with perioral dermatitis were successfully treated with a combination of 1.5 percent erythromycin topical solution twice a day and topically applied hydrocortisone valerate cream. Application of erythromycin solution seems to be an effective topical therapy. Hydrocortisone valerate cream, when used in a controlled, tapered regimen seems to prevent acute rebound flare of perioral dermatitis from previous high-potency steroid use or abuse.

Administration, Topical↗
PubMed1978

[Perioral dermatitis--an allergic disease?].

Perioral dermatitis was diagnosed in 329 patients. Sparing a thin white strip round the red border of the lips erythemas with papules and pseudopustules are arising around the mouth, on nose, eyes, chin, forehead, cheeks and the lateral parts of the neck. The duration of the infection ranged from two weeks up to three years. In many patients the following allergens were detected by patch testing: cosmetics, dental pastes, washing powders, chloric water, mohair, synthetics, and flowers. In 80 patients demodex was discovered. Its role in the pathogenesis of perioral dermatitis is doubtful. Biopsis were taken from 10 patients. Treatment with liquid nitrogen gives good results while antibiotics and corticosteroids are of little effect.

Adult↗
PubMedDate not supplied

[Development of the psychosomatic concept of perioral dermatitis].

In recent years, ,perioral dermatitis' though practically unknown in the past, has been observed rather frequently in female patients. It has proven remarkably refractory against external dermatotherapy, and numerous attempts to analyse the causality have failed. However, we very often noted certain characteristics of personality structure and social attitude in the patients afflicted with the disease. Both clinical findings and various signs of vegetative dystonia suggested psychoneurotic rather than purely somatic causes. We therefore set about to elucidate the psychic and other clinical symptoms of our patients in co-operation with a psychoanalyst and a clinical psychologist. Throughout a period of several years, this interdisciplinary teamwork helped us develop biographically and psychoanalytically oriented case studies in so-called Balint seminars. We thereby gained a better understanding of the psychodynamics in each of our cases, which enabled us to treat the disease successfully. We consider ,perioral dermatitis' a primarily psychosomatic disorder which, in most cases, responds well to short-term psychotherapy. Other findings reported in dermatological literature are controversial as to their causal interpretation, even when assuming an origin by infecting microbes. We regard bacterial and other findings as sequelae which may give rise to clinical exacerbation, yet not as genuine causes of the disease. Our conception is strongly supported by the success of psychotherapy, through which the symptomatic tetracyclin and/or corticosteroid treatment has been rendered superflous.

Adult↗
PubMed1989

[Perioral dermatitis].

A unifying concept of the pathogenesis of perioral dermatitis is presented: perioral dermatitis is a cutaneous intolerance reaction linked to constitutionally dry skin and often accompanied by a history of mild atopic dermatitis. It is precipitated by the habitual use of one or - more often - a variety of moisturizing creams. The type and content of the creams used appear to play a much less important role than the mode of application (regular and abundant). The proposed pathomechanism is: persistent hydration of the horny layer, impairment of barrier function, an proliferation of the skin flora. Topical corticosteroids can aggravate but do not cause perioral dermatitis. This concept of pathogenesis leads to a simple and effective concept of therapy: reduction of the frequency with which moisturizing creams are applied from "regularly" to "as required" (only when dry and smarting skin makes this necessary) generally leads to lasting disappearance of symptoms within approximately 1 month.

Adolescent↗
PubMed1986

Perioral dermatitis: an uncommon condition?

To document the persistence of perioral dermatitis at dermatology clinics at University Hospital, Saskatoon, we reviewed the charts of all patients with the condition seen between January 1983 and March 1985. Patients with rosacea referred to the clinics during the same period were used as a comparison group. A total of 80 patients with perioral dermatitis and 117 patients with rosacea were seen during the study period; most were female. Those with perioral dermatitis were significantly younger and had a significantly shorter mean duration of the eruption before presentation than those with rosacea (p less than 0.001). The distribution of the lesions was different in the two groups. Sixty-eight (85%) of the patients with perioral dermatitis and 45 (38%) of those with rosacea had used topical corticosteroids, a postulated risk factor for perioral dermatitis; the use of potent topical corticosteroids was frequent in both groups. Despite continuing medical education on the dangers of chronic use of these agents for eruptions on the face, physicians continue to prescribe them.

Adrenal Cortex Hormones↗
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↗