Perioral dermatitis
Perioral dermatitis (also: Mouth Rose, stewardesses disease or rosacea -like dermatitis ) is a harmless skin disease with a characteristic rash bläschenhaftem ( " papules ") in the face, especially around the mouth and eyes.
Clinical picture
Most around the mouth ( peri-oral ) or sometimes on the eyelids or their surroundings are usually recognized by numerous, densely packed, smallest, inflammatory erythematous nodules or blisters. A small border around the lips remains free. Sometimes these tiny nodules may coalesce to form larger areas and form plaques. Most often the nasolabial folds, ie the spaces of the nostrils down to the mouth, as well as affected the lateral zones of the chin. This gives the impression of a ring-like distribution.
Cause
The exact cause of the disease is unknown. By Überpflegung the skin is no longer able to even make the necessary fats and lipids, so that it is dry and flaky. Out of ignorance, the affected areas are then more intensively cultivated and creamed, whereupon the rash intensified and expanded. Often there is a genetic predisposition, and perioral dermatitis only breaks out when a trigger comes into play. The most common triggers include stress, fungus, bacteria, fluoride-containing toothpaste and long-term use of cortisone preparations. The complaints appear almost exclusively in women younger to middle age. At the same time, there is often a vegetative lability (headache, insomnia, constipation) and also a connection with partnership or professional continuous loads. Perioral dermatitis is also known as stewardesses disease because a stewardess represents the prototype of a patient: 20-50 years old, well-groomed appearance. This often significantly impaired appearance leads to be used that supposed to care or therapy increasingly cosmetics and skin care products to kortisolhaltigen ointments (often called hydrocortisone ). Through these ointments first occurs while an improvement, but this is only of short duration. Then the rash experienced despite further treatment with Kortisolsalbe a new boost and intensified.
Treatment
For treating the causes mentioned must be eliminated. In particular, the regular application of cosmetic creams ( " moisturizers " ) should be avoided. The affected areas of skin may only be cleaned with water. The discomfort may initially amplified occur: The skin stretches and burns. The inflammatory redness becomes more pronounced. The inflammation can even get oozing character. Then, the patients must apply self- discipline, not to resort to their usual skin care and thereby enter into a vicious circle. If in doubt, the doctor should be consulted. If they manage to do without their cosmetics for about six weeks to three months, the symptoms disappear. First visible results should however be seen partly even after three weeks. It called for the envelopes that are immersed in black tea. Effect in this case, the so-called tannins. This tea gives sufficient tannin, he must pull longer ( > 5-10 minutes) and then cool down sufficiently, since heat would promote the inflammatory process.
Occasionally you may cause an accelerated improvement prescribed medicines (eg, erythromycin gel, azelaic acid gel or metronidazole - containing cream ). In severe inflammatory forms is the use of antibiotics ( tetracyclines, minocycline ) drug of choice. These preparations usually have to be taken for several weeks. Corticosteroids should be avoided because they can lead to an exacerbation after discontinuation or by habituation.
Further treatment must be discussed with the doctor.
Differential Diagnosis
The symptoms can be confused with eczema, acne or rosacea. A seborrheic dermatitis occurs in a similar distribution as the perioral dermatitis. However, the eczema has relatively flat character in contrast to the mostly " pimple -like ", so rather point-like changes in the perioral dermatitis. Often the scaling is more pronounced. In addition, can be found in seborrheic dermatitis in other regions of the face or scalp ( hairy areas, ears, beard area ) eczematous skin lesions. Acne is characterized by a different distribution pattern in the face ( rather cheeks, temples and forehead) and the presence of blackheads ( comedones ). Rosaeca can perioral dermatitis be similar, is not usually around the mouth, but rather on the cheeks or forehead localized. The inflammatory papules are usually somewhat coarser.
Illustration
- Typical image of a perioral dermatitis