Perioral Dermatitis: Clinical Considerations for Dental, Pharmacy, and Nursing Professionals
Abstract
Background: Perioral dermatitis is a common inflammatory facial dermatosis, clinically characterized by erythematous papules and pustules distributed around the mouth, nose, and eyes. It predominantly affects young adult females and is frequently linked to the use of topical corticosteroids, which can initiate a cycle of steroid dependence and rebound flares. The condition's multifactorial etiology also involves other triggers like fluorinated toothpaste, occlusive cosmetics, and skincare products.
Aim: This article aims to synthesize the clinical presentation, pathophysiology, and management of perioral dermatitis for an interprofessional audience, including dental, pharmacy, and nursing professionals. The goal is to enhance recognition, promote trigger identification, and guide effective, steroid-sparing treatment strategies to improve patient outcomes.
Methods: A comprehensive review of the condition is presented, covering its clinical features, histopathology, and epidemiology. Diagnostic approaches based on morphology and exposure history are detailed, alongside a systematic overview of management strategies, including topical and oral therapies, with a strong emphasis on corticosteroid cessation and trigger avoidance.
Results: The cornerstone of management is the immediate discontinuation of all facial corticosteroids, often requiring a structured taper to mitigate rebound flares. First-line therapies include topical metronidazole, calcineurin inhibitors, and azelaic acid. For moderate-to-severe cases, oral tetracyclines are highly effective. Adjunctive measures, such as simplifying skincare routines and substituting potential irritants, are critical for achieving and maintaining remission.
Conclusion: Perioral dermatitis is a frequently mismanaged condition that requires a coordinated, interprofessional approach. Successful outcomes depend on accurate clinical diagnosis, patient education trigger avoidance, and the consistent application of steroid-sparing therapeutic regimens to break the cycle of dependency and inflammation
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Authors
Copyright (c) 2025 Mohammed Ahmed Ali Elshaer, Yasmeen A. Hasanien, Mervat Mostafa Abdel Mageed, Amira Abd-elfattah Darwish, Mohamed Awad Mahmoud Abd-Elraheem
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