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Rosacea (continued)Overview of Treatment for Acneiform Disorders


Perioral Dermatitis
(Periorificial Dermatitis)

  • Definition:  an inflammatory disorder of the skin usually localized to the skin around the mouth, but sparing a rim at the vermilion border
  • Clinical Features
    • Usually occurs in young adults, mainly but not exclusively in females
    • Distribution is primarily on the chin and upper lip with involvement occurring also in the nasal labial folds and around the eyes
    • May be mild itching and burning sensation
    • Individual lesions consist of papules or pustules which often coalesce to form a confluent plaque

  • Variants
    • Are relatively uncommon but involvement may be more asymmetrical around the mouth, and may also be more dominant around the eyes and around the mouth

  • Pathogenesis
    • Like rosacea, is not understood
    • A convincing association has been made with the previous use of fluorinated topical steroids
    • Whether or not this is causative or merely an important aggravating factor, it is important to inquire about the possibility in the history

  • Diagnosis
    • Clinical picture is quite typical
    • Again, the absence of comedones is a critical feature

  • Differential Diagnosis (see Table)
    • Distinction from rosacea is on the basis of distribution but may be difficult
    • Some confusion with seborrheic dermatitis may arise but the presence of pustules and papules excludes this
    • Conversely, the presence of significant erythema and scaling within the scalp or at the hairline is against rosacea


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