Perioral Dermatitis cases | Dermatology Education Perioral Dermatitis cases Video
December 08, 2019

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Perioral Dermatitis cases

This is a typical case of perioral dermatitis. There are pinpoint papules on a red base. Papules are symmetrically distributed around the mouth and involve the nasolabial folds.

Papular pustular acne has a similar appearance. The papules are larger and there is little erythema. Small scars are present on the right chin.

Lesions are frequently asymmetrically distributed in perioral dermatitis. Here tiny papules are concentrated on the left chin and appear eczematous. Involvement of the nasolabial folds and area adjacent to the left nostril help support the diagnosis of perioral dermatitis.

Here erythema, papules and pustules extend from the nostrils onto the nasolabial folds and the upper lip. The chin and lateral eyes are sparred.

This patient had only a few papules that responded to a two week course of doxycycline 100 mg once each day.

Attempts at self treatment with over the counter benzoyl peroxide caused irritation with erythema and some scale. This sensitive area does not tolerate drying therapy. A group 6 topical steroid applied twice each day for 5 days cleared the erythema. The pustules cleared with oral antibiotics.

Diffuse erythema and pustules cleared following a two week course of tetracycline 500 mg twice each day. There had been no attempts at self treatment.

A few pustules were confined to the area adjacent to the nostrils. The eruption had been present for months. Here pustules are more extensive.

Scaling is evident and the papules and pustules are not as discreet as in the previous cases.

This is the classic presentation for perioral dermatitis in the lateral eye area.

Here a few papules are concentrated on the lower lid.

This case is even more subtle with only a few lesions.