"Perioral” refers to the area around the mouth, and “dermatitis” indicates a rash or irritation of the skin. Usually Periorol Dermatitis is characterized by tiny red papules (bumps) around the mouth. The areas most affected by perioral dermatitis are the facial lines from the nose to the sides and borders of the lips, and the chin. The areas around the nose, eyes, and cheeks can also be affected. There are small red bumps, mild peeling, mild itching, and sometimes burning associated with perioral dermatitis. When the bumps are the most obvious feature, the disease can look like acne.
A dermatologist diagnoses perioral dermatitis by examination. No other tests are usually done. Sometimes, scraping or a biopsy of the skin is done. Occasionally, blood tests are ordered to eliminate other conditions that can look similar. A culture for bacteria may sometimes be needed to eliminate the possibility of infection.
Perioral dermatitis is a facial rash that tends to occur around the mouth. Most often it is red and slightly scaly or bumpy. Any itching or burning is mild. It may spread up around the nose, and occasionally the eyes while avoiding the skin adjacent to the lips. It is more rare in men and children. Perioral dermatitis may come and go for months or years. One of the most common factors is prolonged use of topical steroid creams and inhaled prescription steroid sprays used in the nose and the mouth. Overuse of heavy face creams and moisturizers are another common factor. Other factors include skin irritations, fluorinated toothpastes, or other dental fluorinated products. Some dermatologists believe it is a form of rosacea or sunlight-worsened seborrheic dermatitis.
Why perioral dermatitis occurs more frequently in young women is a quandary. However, it may sporadically affect men. Its exact cause is unknown. Perioral dermatitis is a difficult condition to treat effectively, often requiring several months of treatment.
Apparently the following study suggests that topical steroid use increases demodex mite density in perioral dermatitis
Density of Demodex folliculorum in perioral dermatitis.
Dolenc-Voljc M, Pohar M, Lunder T.
Department of Dermatovenereology, University Medical Centre Ljublana, Zaloska 2, SI-1525 Ljublana, Slovenia.
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.
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