Perioral dermatitis

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

  1. Children can have a background of atopic dermatitis. 
  2. Corticosteroid exposure has been noted: topical, oral or inhaled. 
  3. Dental fillings, cosmetics, sunscreens, fluorinated dental products and hormonal changes are associated.
  4. 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

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