Clinical Reference / Therapeutic Strategies / Periorificial Dermatitis

Periorificial Dermatitis


Key Points

  • Periorificial dermatitis is a common acneiform eruption of the face that is marked by erythematous papules, sometimes with scale. Comedones are typically not present and enable its distinction from classic acne.
  • It typically affects the perioral (most common), perinasal, and periocular areas.
  • It may be triggered by use of potent fluorinated topical steroids on the face. It may also be triggered by the use of inhaled steroids and/or topical tacrolimus ointment on the face.

Introduction

Periorificial dermatitis is a common eruption of the face and is marked by erythematous papules, pustules, or papulovesicles (without comedones), sometimes with scale or eczematous appearance. It typically affects the periocular, perinasal, and perioral areas. The perioral area is most commonly affected. When it affects the perioral region, a rim of normal skin usually separates the lips from the affected skin of the chin and cheeks. Patients often report a burning sensation in association with this rash.

This form of dermatitis is frequently related to the use of moderate-to-potent fluorinated topical steroids on the face. Other potential triggers of this condition include inhaled steroids (such as intranasal steroid sprays for allergic rhinitis or bronchial steroid inhalers for asthma), topical tacrolimus, fluorinated toothpaste, and facial cosmetics. In some cases, no triggering factors are found. Although it is considered by some to be related to rosacea, patients usually do not have flushing and other stigmata of rosacea. This condition affects young adult women most commonly.

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