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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↗
PubMed2003

Impaired skin barrier and atopic diathesis in perioral dermatitis.

BACKGROUND: Perioral dermatitis (PD) is a common dermatological disease whose aetiology and pathogenesis remain speculative. We investigated skin barrier function and various markers of the atopic diathesis to elucidate their impact on the development of perioral dermatitis. PATIENTS AND METHODS: Forty patients (24 to 69 years of age) with PD were evaluated. Transepidermal water loss was measured in three regions of the face (lateral chin, perinasal cheek and side of the nose) and the patients were assessed for clinical criteria for atopy. Prick tests were performed, and specific IgE against a mixture of aeroallergens (CAP SX1) was measured. The control group consisted of 62 individuals (20 to 68 years of age) without a history of PD or active disease. RESULTS: Transepidermal water loss was significantly increased (P < 0.001) on all regions of the face in the patient over the control group. Significantly (P < 0.001) higher values were also found for the patient group regarding history (52.5% vs. 17.7%) and clinical signs of atopic diathesis (> or = 4 features: 72.5% vs. 0%), prick test reactivity (> or = 2 reactive prick tests: 60% vs. 12.9%), and specific IgE against aeroallergens (CAP SX1 classes > or = 2: 60.0% vs. 17.7%). CONCLUSIONS: Our findings emphasize the relevance of impaired skin barrier function as a pathogenic factor in the causation of perioral dermatitis. The susceptibility of atopic skin to irritants increases as soon as the skin becomes eczematous. Therefore, we propose that atopic diathesis serves as an intensifier, supporting development and continued presence of perioral dermatitis after nonspecific irritant mechanisms have induced impaired skin barrier function.

Adult↗
PubMed2004

Topical cosmetics and perioral dermatitis.

BACKGROUND: Perioral dermatitis (PD) is a common dermatological disease whose aetiology and pathogenesis remain speculative. Both cosmetics and topical corticosteroids have been implicated. PATIENTS AND METHODS: 75 patients with PD and 125 randomly selected control patients with negative PD records were included in a questionnaire-based study focusing on cosmetics, their use, and topical corticosteroids. The patients were assessed for atopy by clinical criteria, prick tests and specific IgE against a mixture of aeroallergens (CAP SX 1). RESULTS: There were no significant (p < 0.05) differences in facial skin cleansing between the two groups except for night-time cleansing, which was performed more often in the patient group. The use of skin care products yielded significant differences between the patient and control group in respect to skin care in the morning and the use of day creams. Otherwise, the groups did not differ in their skin care regime (number of skin care products used, type of product, frequency of care). The mean monthly expenditure on cosmetic products did not differ significantly between the two groups. 25.3% of the patients used topical corticosteroids which were initiated in all cases after the onset of the rash. Significantly (p < 0.001) higher values were found in the patient group regarding history of atopic diseases (49.3% vs. 15.2%), prick test reactivity (> or =2 reactive prick tests: 49.3% vs. 8.0%), and specific IgE against aeroallergens (CAP SX1 classes > or =2: 50.7% vs. 15.2%). CONCLUSIONS: The often heard argument that PD results mainly from external factors is no longer tenable. A variable interaction between external (e.g. cosmetics) and intrinsic factors (e.g. atopic constitution) appears to lead to PD, perhaps by subclinical repetitive irritation and final overtaxing of the reparative capacity of the epithelial barrier function.

Administration, Topical↗
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↗
PubMed2004

Epithelial barrier function and atopic diathesis in rosacea and perioral dermatitis.

BACKGROUND: Rosacea and perioral dermatitis (PD) are common dermatoses, the aetiology and pathogenesis of which remain speculative. Objectives To investigate skin barrier function and features of atopy in both diseases. METHODS: We studied 75 patients with rosacea and 75 with PD. Transepidermal water loss (TEWL) was measured in three regions of the face (lateral chin, perinasal cheek, side of the nose) and the patients were assessed for atopy by clinical criteria, prick tests and specific IgE against a mixture of aeroallergens (CAP SX1). The control group consisted of 125 individuals with no history of rosacea, PD or active atopic disease. RESULTS: In patients with PD, TEWL was significantly increased (P < 0.001) at all measurement points in comparison with the rosacea and control groups. Significantly (P < 0.001) higher values were also found regarding history and clinical signs of an atopic diathesis, prick test reactivity and specific IgE against aeroallergens. CONCLUSIONS: PD is characterized by a skin barrier disorder of facial skin. It differs from rosacea in that it involves a significantly increased TEWL and features of an atopic diathesis. However, it remains disputed as to whether PD is an individual skin disease or a subtype of rosacea in atopic patients.

Adult↗
PubMed2006

Photodynamic therapy for perioral dermatitis.

BACKGROUND: Treatment of perioral dermatitis (POD) consists of topical steroids, oral antibiotics, and topical antibiotics. OBJECTIVE: To evaluate the safety and efficacy of photodynamic therapy (PDT) with topical 5-aminolevulinic acid (ALA) in the treatment of POD. METHODS: A split-face 21-patient study was conducted in which one side of the face was treated 4 times weekly with ALA PDT (30-minute ALA incubation) with blue light activation and the other side with topical clindamycin. Lesions were counted and photographs were taken before and after the final treatment. Patient satisfaction was also evaluated. RESULTS: Fourteen patients (66.7%) completed the study. Facial sides treated with ALA PDT achieved a mean clearance of 92.1% compared to 80.9% for the clindamycin-treated sides. The difference was significant (P=0.0227). The mean patient satisfaction level for the ALA PDT-treated side was 4.4 (1-5 scale). CONCLUSION: ALA PDT may be a promising alternative to antibiotics for the treatment of POD.

Adolescent↗
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↗
PubMed2005

Density of Demodex folliculorum in perioral dermatitis.

The role of Demodex folliculorum in perioral dermatitis is not satisfactory explained. Our purpose was to assess the density of D. folliculorum in perioral dermatitis and evaluate the relationship of the mite count to previous therapy with topical steroids. A standardized skin surface biopsy of the chin was performed in 82 female patients with perioral dermatitis and in 70 control female subjects. Patients who received previous topical steroid therapy had a significantly higher mite density than the patients who had received no topical steroids (p<0.001). In the latter group of patients, the mite density did not differ significantly from that of the control group (p=0.629). Mite density increased significantly with the length of treatment with topical steroids (p<0.001). Our results suggest that increased density of D. folliculorum in perioral dermatitis is a secondary phenomenon, associated with topical steroid therapy.

Administration, Cutaneous↗
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↗