Perioral-nasal-ocular dermatitis
Perioral-nasal-ocular dermatitis a type of dermatitis that occurs only around the mouth, nose and eyes. It does not have to be present in all of the areas at the same time. Some people believe that Perioral-nasal-ocular dermatitis does in fact not exist and that people that fit the clinical picture of Peri-ral-nasal-ocular dermatitis are in fact suffering from Rosacea.
Rosacea and Perioral-nasal-ocular dermatitis can occur together. Because it is always more likely that someone is suffering from 1 condition rather than 2 conditions at the same time, the above mentioned phenomenon lends support to the thesis that Rosacea and Perioral-nasal-ocular dermatitis is the same condition with 2 slightly different clinical expressions.
Histologically, i.e. when looking at a piece of skin under the microscope that has been obtained by biopsy from a patients face, both Rosacea and Perioral-nasal-ocular dermatitis displays the same type of inflammation, knows as a granulomatous peri-folliculitis. The word granulomatous refers to a collection of macrophages (a type of white blood cell). Peri-folliculitis means that the "collection of macrophages" is lying in close proximity to a hair follicle.
Whether or not Rosacea and Perioral-nasal-ocular dermatitis is the same disease or two separate diseases, might be a question that is more important from an academic viewpoint than from the patients viewpoint. The fact is that the clinical picture known as Perioral-nasal-ocular dermatitis is quite classic and most often easily recognizable and treatable.
Classically young female patients are affected. The rash consists of small red bumps (knows as papules) and occasionally small pimples (knows a pustules) occurring around the mouth, nose and eyes. Interestingly, a small margin of skin around the edge of the lips are always unaffected. As mentioned before not all 3 of these areas has to be affected at the same time.
More than 80% of patients with Perioral-nasal-ocular dermatitis have been applying corticosteroid-containing creams to the face, before the rash started to appear. In the remaining cases the cause is unclear, but the excessive use of facial cosmetics seems to be another common factor.
The treatment of this condition involved the stopping of all (if possible) topical creams and lotions that the patient are using. If topical corticosteroid-containing creams have been used they should be tapered off slowly and not stopped suddenly, because this will lead to a flare-up of the condition.
The treatment of Perioral-nasal-ocular dermatitis involves the use of oral tetracycline antibiotics for a few months. Sometimes this is combined with antibiotic creams, but in general it is better to avoid as many creams as possible. Most often this approach results in complete clearance of the skin condition in a few weeks.
Rosacea and Perioral-nasal-ocular dermatitis can occur together. Because it is always more likely that someone is suffering from 1 condition rather than 2 conditions at the same time, the above mentioned phenomenon lends support to the thesis that Rosacea and Perioral-nasal-ocular dermatitis is the same condition with 2 slightly different clinical expressions.
Histologically, i.e. when looking at a piece of skin under the microscope that has been obtained by biopsy from a patients face, both Rosacea and Perioral-nasal-ocular dermatitis displays the same type of inflammation, knows as a granulomatous peri-folliculitis. The word granulomatous refers to a collection of macrophages (a type of white blood cell). Peri-folliculitis means that the "collection of macrophages" is lying in close proximity to a hair follicle.
Whether or not Rosacea and Perioral-nasal-ocular dermatitis is the same disease or two separate diseases, might be a question that is more important from an academic viewpoint than from the patients viewpoint. The fact is that the clinical picture known as Perioral-nasal-ocular dermatitis is quite classic and most often easily recognizable and treatable.
Classically young female patients are affected. The rash consists of small red bumps (knows as papules) and occasionally small pimples (knows a pustules) occurring around the mouth, nose and eyes. Interestingly, a small margin of skin around the edge of the lips are always unaffected. As mentioned before not all 3 of these areas has to be affected at the same time.
More than 80% of patients with Perioral-nasal-ocular dermatitis have been applying corticosteroid-containing creams to the face, before the rash started to appear. In the remaining cases the cause is unclear, but the excessive use of facial cosmetics seems to be another common factor.
The treatment of this condition involved the stopping of all (if possible) topical creams and lotions that the patient are using. If topical corticosteroid-containing creams have been used they should be tapered off slowly and not stopped suddenly, because this will lead to a flare-up of the condition.
The treatment of Perioral-nasal-ocular dermatitis involves the use of oral tetracycline antibiotics for a few months. Sometimes this is combined with antibiotic creams, but in general it is better to avoid as many creams as possible. Most often this approach results in complete clearance of the skin condition in a few weeks.
posted by Nick Riley at 11:36 AM
