Core Dermatology Diagnoses / CategoriesInflammatory

Perioral dermatitis

Author: Deputy Editor: Faculty Reviewer:

Publish date: Posted on
Last updated: October 21, 2023

Keywords #

perioral dermatitis
periorificial dermatitis
POD

Diagnosis #

Periorificial dermatitis is an inflammatory dermatosis that typically presents as itchy or tender erythematous papules or pustules, with or without scale around the mouth, eyes, and nose. The etiology is currently unknown, but is associated with topical or nasal steroid use and cosmetic products [1, 2, 3]. 

Key Concepts #
  • Periorifical dermatitis is an inflammatory reaction around the facial orifices. 
  • The etiology is unknown but is associated with steroid or cosmetic use. 
  • It is most commonly diagnosed in children or young and middle-aged women. 
Epidemiology #

Periorificial dermatitis is more commonly seen in women of age 15-45 or in children. The prevalence is reported to be approximately 0.3% [4]. 

Clinical Features #

Inflammatory papules or pustules on an erythematous base surrounding the mouth, nose, and/or eyes. 

Differential Diagnoses #
Diagnostic Workup #

No diagnostic workup is necessary as perioral dermatitis is considered a clinical diagnosis [5].

Treatment #

Perioral dermatitis can be treated with topical anti-inflammatories or topical antibiotics for 4-8 weeks. In severe cases, oral antibiotics or low-dose oral isotretinoin may be used [2, 5, 6]. Topical corticosteroids should be avoided because they will cause rebound flaring. 

Slide Viewer #
https://utahderm.med.utah.edu/image-viewer/
References #
  1. Dirschka, T. et al. “Topical Cosmetics and Perioral Dermatitis.” J Dtsch Dermatol Ges, vol. 2, no. 3, 2004, pp. 194-199, doi:10.1046/j.1439-0353.2004.04764.x.  
  2. Goel, N. S. et al. “Pediatric Periorificial Dermatitis: Clinical Course and Treatment Outcomes in 222 Patients.” Pediatr Dermatol, vol. 32, no. 3, 2015, pp. 333-336, doi:10.1111/pde.12534. 
  3. Wilkinson, D. S. et al. “Perioral Dermatitis: A 12-Year Review.” Br J Dermatol, vol. 101, no. 3, 1979, pp. 245-257, doi:10.1111/  
  4. Hoepfner, A. et al. “Rosacea and Perioral Dermatitis: A Single-Center Retrospective Analysis of the Clinical Presentation of 1032 Patients.” J Dtsch Dermatol Ges, vol. 18, no. 6, 2020, pp. 561-570, doi:10.1111/ddg.14120.  
  5. Tempark, T. and T. A. Shwayder. “Perioral Dermatitis: A Review of the Condition with Special Attention to Treatment Options.” Am J Clin Dermatol, vol. 15, no. 2, 2014, pp. 101-113, doi:10.1007/s40257-014-0067-7.  
  6. Rodriguez-Garijo, N. et al. “Recalcitrant Granulomatous Periorificial Dermatitis with Good Response to Low-Dose Oral Isotretinoin.” Pediatr Dermatol, vol. 36, no. 6, 2019, pp. 980-981, doi:10.1111/pde.13969. 
Contents