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Perioral dermatitis - External and Internal Eye
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Perioral dermatitis - External and Internal Eye

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Contributors: Susan Burgin MD, Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
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Synopsis

Perioral dermatitis : Chin, Erythema, Inferior eyelid, Lateral canthus, Lips, Perioral, Smooth papules, Cheeks
This summary discusses perioral dermatitis in adults. Perioral dermatitis in children is addressed separately.

Perioral dermatitis is a localized inflammatory disorder of uncertain etiology. It manifests as an erythematous papular and pustular eruption involving the nasolabial folds, the upper and lower cutaneous lip, and the chin. The lip margin and the immediate circumoral area are typically spared. Periorbital involvement, predominantly the lower and lateral eyelids, may occur. The term "periorificial dermatitis" is then applied.

Fine scaling may be seen. The eruption may be asymptomatic, but burning or itch may be encountered. The granulomatous variant comprises more substantive papules in a similar distribution.

Perioral dermatitis is seen almost exclusively in women aged between 18 and 40. A number of factors have been implicated in causing this condition, such as topical fluorinated glucocorticoids (including inhalers), fluorinated toothpastes, and oral contraceptives.

Codes

ICD10CM:
L71.0 – Perioral dermatitis

SNOMEDCT:
238751002 – Perioral dermatitis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated:06/13/2016
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Patient Information for Perioral dermatitis - External and Internal Eye
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Perioral dermatitis : Chin, Erythema, Inferior eyelid, Lateral canthus, Lips, Perioral, Smooth papules, Cheeks

Overview

Perioral dermatitis is an acne-like condition that typically occurs around the mouth, nose, and/or around the eyes (also known as periorbital dermatitis). Some possible causes are the use of topical corticosteroid creams, certain cosmetic products, oral contraceptives, and fluoride and anti-tartar ingredients in dental products. Perioral dermatitis also tends to occur in those prone to eczema.

Who’s At Risk

Perioral dermatitis is usually seen in women aged 18-40, but men can be affected as well. Children may also be affected.

Signs & Symptoms

Tiny papules (solid bumps) or pustules (pus-filled bumps) appear around the mouth, often with a clear area between the lip and the rash. The bumps may also occur near the eyes and nose. There may be dry, flaky skin in these areas. In lighter skin colors, the rash may appear pink or red. In darker skin colors, the redness may be harder to see, or it may appear purple or darker brown. The lesions may burn or itch or have no symptoms at all.

Self-Care Guidelines

  • Stop all face creams, lotions, cosmetics, and sunscreens being used.
  • Stop any dental products with fluoride and anti-tartar ingredients.
  • Wash with warm water alone until the rash improves, and then use a gentle cleanser such as Dove, CeraVe, or Cetaphil to clean your face.
  • If you have been applying a steroid-containing product, this will need to be stopped. However, if it has been used for a long time, it may cause the perioral dermatitis to get worse for a period.

When to Seek Medical Care

If the self-care measures are not helping after a couple of weeks or if the condition gets worse, seek medical advice.

Treatments

  • Topical antibiotic gels, creams, solutions, or lotions (eg, metronidazole [Flagyl], clindamycin [Cleocin T], azelaic acid [Azelex, Finacea], pimecrolimus [Elidel], or erythromycin [E.E.S.]).
  • Oral antibiotics, such as doxycycline (Oracea, Doryx, Vibramycin).
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Perioral dermatitis - External and Internal Eye
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A medical illustration showing key findings of Perioral dermatitis : Chin, Erythema, Inferior eyelid, Lateral canthus, Lips, Perioral, Smooth papules, Cheeks
Clinical image of Perioral dermatitis - imageId=326179. Click to open in gallery. caption: 'Multiple tiny erythematous papules coalescing to form a plaque, with minimal scale at the oral commissure. Note the sparing of the lip margin.'
Multiple tiny erythematous papules coalescing to form a plaque, with minimal scale at the oral commissure. Note the sparing of the lip margin.

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