Perioral dermatitis

PERIORAL DERMATITISPresented By:

Ira Ulil Inayah WahidC 111 07 239Christya Lorena GC 111 07 263Siti Alis Solihan bt Ramli C 111 07 295

Advisor:dr. Hartati

Supervisor:dr. Dirmawati Kadir, Sp. KK11Introduction:

Perioral dermatitis (PD) is an eruption of papules or small papulopustules around the mouth. Usually as a respond to topical corticosteroid or cosmetics used.Its manifests as scaling, papules or papulopustules with erithematous background.22Epidemiology Perioral dermatitis (PD) is most commonly found in young women at their age of 15-40 years old with peak incidens at 25-35 years old.In children girls and boys are in the same risk to develop PD3Etiology:

Medications: misused of topical corticosteroidCosmetics: toothpaste (due to the contain of flouride), lotion and cream which contain paraffin and isopropyl myristate

4Etiology:

Physical factors: UV light, hot and polluted airMicrobiology factors: Fusiform spirillia, Candidia, and Demodex folliculorumOther factors: hormonal factors, oral contraception, malabsorptions55Pathogenesis The exact pathogenesis of PD is unknown.But it is assumed that edema and vasodilatation of papillary dermis, perivascular and also infiltration of lymphocyte, histiocyte and PMN in parafollicular6Diagnosis Anamnesis: 1. Usually the lesion appears for weeks to months 2. Itchy usually absent3. Burning sensation usually absent

7Diagnosis Lesion characteristics: 1. Erythematous papulopustules on an erythematous background, symmetry, grouped as satellite . 2. Confluent plaques may appear eczematous with tiny scales. There are no comedones.

8Diagnosis:

Predillections: Initially perioral. Rim of sparing around the vermilion border of lips.

9Differential diagnosis

Allergy Contact dermatitisAtopic dermatitisSeborrhoic dermatitisRosaseaAcne vulgarisDermatitis liplicker10Dermatitis perioralDermatitis perioralAllergy contact dermatitisAtopic dermatitisSeborrhoic dermatitisRosasea Acne vulgarisDermatitis liplicker

11Management: 1. Nonmedication:Identify the causative agent (cosmetic or topical corticosteroid etc) and stop the usage. Beware of rebound phenomenon for corticosteroid usage.12Management:2. Medication:- Topical antibiotic most commonly use is Metronidazole- Systemic antibiotic most commonly used is Tetracyclin - Calcineurine inhibitor topical - Photodinamic therapy (5-aminolevulinic topical)

13TOPIKALDOSISSISTEMIKDOSISFirst lineMetronidazol 2 x 1TetrasiklinDoksisiklinMinosiklin250-500 mg 2x1/hr50-100 mg 2x1/hr50-100 mg 2x1/hrSecond lineEritromisinatauKlindamisinSulfurAsam azelaic2 x 12 x 12 x 12 x 1Eritromisin 400 mg 3x1/hratau30-50 mg/kgBB/hr14Complication:

Psychological and can cause lack of self confidenceRebound phenomena due to stoppage of corticosteroid15Prognosis: Cureable with broad spectrum antibioticsRelapse to some patientsIf not immediately treated or if topical corticosteroid is continously used this PD can progress to years

16Conclusion:PD is eruption of Perioral dermatitis is an eruption of papules or small papulopustules around the mouth. Usually as a respond to topical corticosteroid or cosmetics used.Its manifests as scaling, papules or papulopustules with eritematous background.

17Conclusion: Perioral dermatitis (PD) is most commonly found in young women at their age of 15-40 years old with peak incidens at 25-35 years old.To manage PD, stop the usage of causative agent. Give topical antibiotic (Metronidazole), systemic antibiotic most commonly used is Tetracyclin18Thank You19