Perioral dermatitis in children typically presents as multiple small flesh-colored or erythematous inflamed papules or micronodules around the mouth, nose and eyes. The age ranges from 7 months to 13 years.
Causes
- Children can have a background of atopic dermatitis.
- Corticosteroid exposure has been noted: topical, oral or inhaled.
- Dental fillings, cosmetics, sunscreens, fluorinated dental products and hormonal changes are associated.
- Fusobacterium & Candida albicans may also contribute.
Treatment
- Suspected causative agents such as topical corticosteroids should be discontinued.
- Mild cases may be treated with a topical antibiotic such as metronidazole or clindamycin. Clearance in 3-8 weeks.
- Refractory or moderate to severe disease is treated with oral antibiotics
> 12 years : Oral doxycycline
< 12 years : Clarithromycin
Other Treatments
- 1% topical ivermectin
- Topical tacrolimus/Pemicrlimus
- 20% Azelaic cream
Image courtesy https://www.mdedge.com
Pediatric Practice... Pearls for your Pediatric Office Practice 