Chapter 2. Perioral Dermatitis
The term "perioral dermatitis" is generally used for a papulopustular or granulomatous eruption that may be idiopathic but commonly occurs in association with chronic use of topical corticosteroids to the face. The rash is eczematous, but tends to be more papular in appearance than facial irritant dermatitis (PICTURE A). Lesions are seen in the perioral and naso-labial area but may extend to the cheeks, eyelids and forehead in more severe cases. Treatment consists primarily of oral antibiotics such as erythromycin and tetracycline but topical agents such as benzoyl peroxide, antibiotic combinations, calcineurin inhibitors and keratolytics may be useful adjuncts. Topical corticosteroids are used sparingly, if at all, to avoid side effects associated with long-term exposure.