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Chapter 21: Perioral Dermatitis

INTRODUCTION

KEY POINTS

  • Perioral dermatitis can involve the cheeks, nasolabial folds, and chin in all skin types.

  • It can occur secondary to long-term topical steroid use, which can be found in many skin-lightening products used in populations with skin of color.

  • Clinically it can present with pink to skin-colored papules on lighter skin with intense background erythema. In contrast, darker skin tends to present with skin-colored to pink-brown papules with less visible background erythema and pigmentation.

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FIGURE 21-1.

Periorally and perinasally clustered and confluent pink and pink-brown papules of varying sizes. Note the visible pink erythema inferior to the mid-lower lip. (Reproduced with permission from Prose NS, Kristal L. Weinberg’s Color Atlas of Pediatric Dermatology, 5th ed. New York, NY: McGraw Hill; 2017, Figure 2-40.)

A patient with brown skin with clusters of pink to brown papules of different sizes surrounding the mouth.
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FIGURE 21-2.

Perioral pink and light-brown papules of varying sizes extending up to the cheek and infraorbital skin. (Reproduced with permission from Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology, 9th ed. New York, NY: McGraw Hill; 2019, Figure 80-6.)

A patient with numerous inflammatory papules and pustules, and overlying scale scattered around mouth and nose, extending to the lower eyelids.
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FIGURE 21-3.

Pink confluent papules and plaques on the medial cheeks and periorally in a young Asian woman. (Reproduced with permission from Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology, 9th ed. New York, NY: McGraw Hill; 2019, Figure 104-6.)

A photo shows red rashes around a girl's mouth and nose.
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FIGURE 21-4.

Bright-red papules overlying an erythematous patch lateral to the commissures and on the chin. (Reproduced with permission from Desman GT, Barnhill RL. Barnhill’s Dermatopathology Challenge: Self-Assessment & Review. New York, NY: McGraw Hill; 2016, Chapter 2.)

A photo shows red papules in the chin and perioral region. The skin in those regions appears bright red.
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