Perioral dematitis in a young male with a history of licking his lips.
|Classification and external resources|
Perioral dermatitis (also called periorifical dermatitis), is skin disease characterised by multiple small (1 – 2 mm) papules, pustules and vesicles which are localized to the perioral skin (around the mouth), perinasal or nasolabial folds (around the nostrils), or perioccular area (around the eyes). It most commonly affects women between the ages of 20 and 45 years, but may also affect children, men and the elderly. It is not uncommon, and has a tendency to recur in individuals who have had it once.
Symptoms and signs
Perioral dermatitis may be asymptomatic, or may be associated with a burning, stinging sensation in the affected areas.
When periorbital dermatitis is found in otherwise healthy prepubertal children, with a profusion of grouped papules on the perioral, periocular, and perinasal areas, the condition is referred to as Granulomatous perioral dermatitis.
There are a large number of potential causes including chewing gum, certain medications, hormone changes, and autoimmune diseases. Lip licking, lip chewing, sucking, and allergies to ingredients in certain dental products have also been reported as causes. Balsam of Peru and cinnamic aldehyde (both often used as flavoring in food, lipstick, mouthwash, and toothpaste), rosin in some chewing gum, cinnamon, and peppermint are other potential allergens that may cause perioral dermatitis.
A diagnosis of perioral dermatitis is typically made based on the characteristics of the rash. A skin biopsy is usually not required to make the diagnosis, but can be helpful to rule out other skin diseases which may resemble perioral dermatitis.
Other skin diseases which may resemble perioral dermatitis include:
- Acne vulgaris
- Seborrheic dermatitis
- Allergic contact dermatitis
- Irritant contact dermatitis
Perioral dermatitis will usually resolve within a few months without medication. Topical corticosteroids should be stopped entirely if possible.
A number of medications speed up recovery including: tetracycline, doxycycline and erythromycin. Erythromycin may be used as a cream. Metronidazole does not appear to be as good as tetracycline.
- "Perioral Dermatitis - Patient pamphlet". American Academy of Dermatology. 2006. Retrieved April 3, 2006.
- Hans J Kammler (February 23, 2005). "Perioral Dermatitis". American Academy of Dermatology. Retrieved April 3, 2006.
- James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. Page 250. ISBN 0-7216-2921-0.
- Tempark, T; Shwayder, TA (Apr 2014). "Perioral dermatitis: a review of the condition with special attention to treatment options.". American journal of clinical dermatology 15 (2): 101–13. doi:10.1007/s40257-014-0067-7. PMID 24623018.
- Pudupakkam K. Vedanthan, Harold S. Nelson, Shripad N. Agashe, Mahesh P A, Rohit Katial (2014). Textbook of Allergy for the Clinician. CRC Press. Retrieved May 1, 2014.
- Jennifer Cafardi (2012). The Manual of Dermatology. Springer. Retrieved May 1, 2014.
- Hall, CS; Reichenberg, J (August 2010). "Evidence based review of perioral dermatitis therapy.". Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia 145 (4): 433–44. PMID 20823788.
- U.S. National Library of Medicine (December 11, 2009) 'Perioral dermatitis'. Retrieved August 7, 2010.