Perioral Dermatitis: Still a Therapeutic Challenge
Perioral dermatitis is a common and often chronic dermatosis. In its classic form, it primarily affects women aged 15 to 45 years, but there are also variants including lupus-like and granulomatous perioral dermatitis, where granulomatous form is more common in childhood and affects mostly prepubesc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Sestre Milosrdnice University hospital, Institute of Clinical Medical Research
2015-01-01
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| Series: | Acta Clinica Croatica |
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| Online Access: | http://hrcak.srce.hr/file/214281 |
| _version_ | 1811252661323825152 |
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| author | Zrinka Bukvic Mokos Ana Kummer Elvira Lazić Mosler Romana Čeović Aleksandra Basta-Juzbašić |
| author_facet | Zrinka Bukvic Mokos Ana Kummer Elvira Lazić Mosler Romana Čeović Aleksandra Basta-Juzbašić |
| author_sort | Zrinka Bukvic Mokos |
| collection | DOAJ |
| description | Perioral dermatitis is a common and often chronic dermatosis. In its classic form, it primarily affects women aged 15 to 45 years, but there are also variants including lupus-like and granulomatous perioral dermatitis, where granulomatous form is more common in childhood and affects mostly prepubescent boys. The etiopathogenesis of the disease remains unclear, but there is a frequent finding of prolonged use of topical products, especially corticosteroids, in the treatment of rosacea and seborrheic dermatitis, preceding the clinical manifestation of perioral dermatitis. Other causes important for the occurrence of the disease include various skin irritants, as well as other physical and hormonal factors, which all share the epidermal barrier dysfunction as an underlying main pathogenic factor. Clinical presentation of papulovesicular eruption in the perioral region with a typical narrow spared zone around the edge of the lips is characteristic. Therapeutic approach should be individually addressed, depending on the severity of clinical presentation and patient’s age, with special attention to patient’s education and continuous psychological support. In mild forms of perioral dermatitis, ‘zero therapy’ is the treatment of choice. In the initial treatment period, patients with steroid-induced perioral dermatitis should be closely followed up because the rebound phenomenon usually develops after cessation of previous topical treatment. In moderate disease, treatment includes topical metronidazole, erythromycin, and pimecrolimus, whereas in more severe cases the best validated choice is oral tetracycline in a subantimicrobial dose until complete remission is achieved. Systemic isotretinoin should be considered as a therapeutic option for patients refractory to all standard therapies. |
| first_indexed | 2024-04-12T16:38:00Z |
| format | Article |
| id | doaj.art-deb4047b3c7a44eca8c5648558bdfab2 |
| institution | Directory Open Access Journal |
| issn | 0353-9466 1333-9451 |
| language | English |
| last_indexed | 2024-04-12T16:38:00Z |
| publishDate | 2015-01-01 |
| publisher | Sestre Milosrdnice University hospital, Institute of Clinical Medical Research |
| record_format | Article |
| series | Acta Clinica Croatica |
| spelling | doaj.art-deb4047b3c7a44eca8c5648558bdfab22022-12-22T03:24:55ZengSestre Milosrdnice University hospital, Institute of Clinical Medical ResearchActa Clinica Croatica0353-94661333-94512015-01-0154.2.179184Perioral Dermatitis: Still a Therapeutic ChallengeZrinka Bukvic Mokos0Ana Kummer1Elvira Lazić Mosler2Romana Čeović3Aleksandra Basta-Juzbašić4University Department of Dermatology and Venereology, Zagreb University Hospital Center, School of Medicine, University of Zagreb, Zagreb, CroatiaBlaženka Tomić-Kummer Pediatric Office, Zaprešić, CroatiaDr. Ivo Pedišić General Hospital, Sisak, CroatiaUniversity Department of Dermatology and Venereology, Zagreb University Hospital Center, School of Medicine, University of Zagreb, Zagreb, CroatiaUniversity Department of Dermatology and Venereology, Zagreb University Hospital Center, School of Medicine, University of Zagreb, Zagreb, CroatiaPerioral dermatitis is a common and often chronic dermatosis. In its classic form, it primarily affects women aged 15 to 45 years, but there are also variants including lupus-like and granulomatous perioral dermatitis, where granulomatous form is more common in childhood and affects mostly prepubescent boys. The etiopathogenesis of the disease remains unclear, but there is a frequent finding of prolonged use of topical products, especially corticosteroids, in the treatment of rosacea and seborrheic dermatitis, preceding the clinical manifestation of perioral dermatitis. Other causes important for the occurrence of the disease include various skin irritants, as well as other physical and hormonal factors, which all share the epidermal barrier dysfunction as an underlying main pathogenic factor. Clinical presentation of papulovesicular eruption in the perioral region with a typical narrow spared zone around the edge of the lips is characteristic. Therapeutic approach should be individually addressed, depending on the severity of clinical presentation and patient’s age, with special attention to patient’s education and continuous psychological support. In mild forms of perioral dermatitis, ‘zero therapy’ is the treatment of choice. In the initial treatment period, patients with steroid-induced perioral dermatitis should be closely followed up because the rebound phenomenon usually develops after cessation of previous topical treatment. In moderate disease, treatment includes topical metronidazole, erythromycin, and pimecrolimus, whereas in more severe cases the best validated choice is oral tetracycline in a subantimicrobial dose until complete remission is achieved. Systemic isotretinoin should be considered as a therapeutic option for patients refractory to all standard therapies.http://hrcak.srce.hr/file/214281Dermatitis, perioral – etiologyDermatitis, perioral – therapyIndividualized medicine |
| spellingShingle | Zrinka Bukvic Mokos Ana Kummer Elvira Lazić Mosler Romana Čeović Aleksandra Basta-Juzbašić Perioral Dermatitis: Still a Therapeutic Challenge Acta Clinica Croatica Dermatitis, perioral – etiology Dermatitis, perioral – therapy Individualized medicine |
| title | Perioral Dermatitis: Still a Therapeutic Challenge |
| title_full | Perioral Dermatitis: Still a Therapeutic Challenge |
| title_fullStr | Perioral Dermatitis: Still a Therapeutic Challenge |
| title_full_unstemmed | Perioral Dermatitis: Still a Therapeutic Challenge |
| title_short | Perioral Dermatitis: Still a Therapeutic Challenge |
| title_sort | perioral dermatitis still a therapeutic challenge |
| topic | Dermatitis, perioral – etiology Dermatitis, perioral – therapy Individualized medicine |
| url | http://hrcak.srce.hr/file/214281 |
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