Last Updated: 2023-07-07
Author(s): Anzengruber F., Navarini A.
- Frumess and Lewis, 1957
- Mihan and Ayres, 1964
Dermatitis perioralis, rosacea-like dermatitis, stewardess disease, periorificial dermatitis.
Reactive disease of the face, rosacea type. Itchy to painful skin changes on the face. Not infectious.
- Incidence: approx. 1%/y.
- Peak in age: 20-40 y.
- Women >> men.
- Professions with make-up compulsion more often affected ("stewardess disease")
- Caused by excessive use of skin care products, cosmetics, sun creams
- Predisposed individuals include atopics
- Vicious cycle when using topical glucocorticoids
- UV light (is not a sole trigger, but can lead to worsening)
The disease is close to rosacea, but the distribution is different. The skin changes are always found around an orificium: perioral, perinasal and/or periorbital erythematous, often grouped, pruritic to burning, confluent, often slightly scaly papules, papulovesicles and pustules, sometimes also thin plaques.
- Clinical picture
- No laboratory tests necessary
- In case of doubt, trial excision
- Perioral, periocular, perinasal
- Regular recess of about 1-2 mm of the skin directly adjacent to the orificium, because there are no vellus hair follicles in this zone, but they are necessary for follicular-bound disease
Follicular centred pathology. Epidermis spongiotic, lymphocytic perivascular infiltrates around follicular ostia. No demodex mites, telangiectasias, actinic elastosis as in rosacea.
If possible, abstain from facial care products.
- Only when patients acknowledge the trigger does improvement occur
- Frequently protracted
- Poor adherence to cosmetic abstinence leads to recurrence
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