Periorificial Dermatitis

Periorificial dermatitis is an inflammatory skin disorder that is characterised by eruption of multiple erythematous papules and pustules around the orifices – eyes, nose, and mouth. Most cases are associated with topical steroids or cosmetics. It commonly affects young women.

• Causes
  • Idiopathic
  • Topical corticosteroids (direct and indirect application)
  • Infection by Candida albicans and fusiform bacteria
  • Cosmetics and skincare
  • Flouride toothpaste
  • Hormonal changes
• Signs and symptoms
  • Classic type: Clusters of follicular papules and pustules over an erythematous base
    • +/- scaling
    • Skin surrounding the mouth, nose, and eyes
    • Spares the vermilion border in the mouth
    • Burning or stinging
    • Pruritus may be present
  • Granulomatous type: flesh coloured papules or plaques
    • Less prominent erythema and scaling
• Differentials
  • Acne rosacea
  • Avne vulgaris
  • Seborrhoeic dermatitis
  • Allergic contact dermatitis
• Treatment
  • Self-limiting
  • Zero therapy – discontinue topical facial products
  • Topical antibiotics, tacrolimus or pimecrolimus for patients with mild localized disease
  • Oral antibiotics for patients with extensive disease