Periorificial dermatitis in children and adolescents

Background. There has been very little evaluation of the history, morphology, or disease course of perioral/periorificial dermatitis in children. Objective: We sought to elucidate the clinical manifestations and treatment outcomes in this condition. Methods: A retrospective chart review with telephone follow-up was used to study 79 children and adolescents. Results: Patients ranged from 6 months to 18 years of age. The average duration of the rash at presentation was 8 months. Seventy-two percent had a history of topical, inhaled, or systemic steroid exposure. Seventy percent of patients had perioral involvement, 43% perinasal, and 25% periocular involvement. A perivulvar rash was reported in 1% of patients. Treatment with topical metronidazole was associated with clearing on follow-up examination. Limitations: This is a retrospective study without case controls and is subject to interviewer and memory bias. Conclusion. Perioral dermatitis appears at all ages in childhood and adolescence and may be associated with topical corticosteroid use. It may be responsive to topical metromdazole in children and adolescents and is more appropriately termed periorificial dermatitis.