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Perioral dermatitis is a common inflammatory skin disease presenting as tiny papules or pustules localized around the mouth, nose, or eyes. It is often confused with acne vulgaris, rosacea, and seborrheic dermatitis. The condition's precise etiology remains unknown, though it is often triggered by topical corticostero i d s. Oral and topical antibiotics are the mainstays of treatment.
OBJECTIVES
This continuing nursing educational (CNE) activity is designed for nurses and other health care providers who care for and educate patients and their families regarding perioral dermatitis. For those wishing to obtain contact hour credit, an evaluation follows. After reading the following article, the nurse will be able to:
1. Define perioral dermatitis and distinguish it from common imitators.
2. Recognize etiologic factors that may cause or exacerbate perioral dermatitis.
3. Choose appropriate treatments for perioral dermatitis in children and adults, including challenging cases.
Perioral dermatitis (POD) is a common facial eruption of women and children, presenting as tiny papules and pustules, often in a perioral distribution. It is sometimes confused with acne vulgaris, rosacea, or seborrheic dermatitis. POD is a relatively recently described condition, with the first reports appearing in the dermatologic literature in the late 1950s and early 1960s (Frumess & Lewis, 1957; Mihan & Ayres, 1964). This raises the question of whether the disease existed before but was not reported or whether some exposure that began in the 1950s may have provoked POD in susceptible persons. It is interesting to note that both fluoride- containing toothpastes and potent topical corticosteroids became widely available during this era, and both of these have been implicated in the etiology of this condition. Perioral dermatitis is now more correctly referred to as "periorificial dermatitis," since it frequently involves perinasal and periocular skin.
Epidemiology
POD primarily affects two populations: children aged 6 months to 16 years old, with boys and girls both affected, and women ages 17- 45 years old (Sneddon, 1972; Wilkinson, Kirton, & Wilkinson, 1979). All races are affected. POD is thought to have been most common in the 1960s and 1970s, with a decline in cases in the 1980s and 1990s. This may reflect widespread prescription of strong topical corticosteroids for use on the face in the 1960s and 1970s before their side...