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2.
J Cosmet Dermatol ; 20(12): 3839-3848, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33751778

RESUMO

BACKGROUND AND AIMS: Perioral dermatitis is a common cutaneous condition characterized by acneiform facial eruptions often with an eczematous appearance. A granulomatous subtype exists in addition to the classic variant. While topical corticosteroids have been largely implicated in this condition, its etiology is not completely understood. METHODS: Using the keywords "corticosteroids," "dermatology," "fusobacteria," "perioral dermatitis," and "periorificial dermatitis," we searched the databases PubMed, MEDLINE, and EMBASE to find the relevant literature. Only articles in English were chosen. The level of evidence was evaluated and selected according to the highest level working our way downwards using the Oxford Centre of Evidence-Based Medicine 2011 guidance. RESULTS: This systematic review found the strongest evidence to support topical corticosteroid misuse as the principal causative factor in the pathogenesis of perioral dermatitis. CONCLUSION: In terms of treatment, further research is required to robustly investigate promising treatment options including tetracyclines, topical metronidazole, topical azelaic acid, adapalene gel, and oral isotretinoin.


Assuntos
Dermatite Perioral , Fármacos Dermatológicos , Antibacterianos/uso terapêutico , Dermatite Perioral/diagnóstico , Dermatite Perioral/tratamento farmacológico , Dermatite Perioral/etiologia , Fármacos Dermatológicos/uso terapêutico , Humanos , Isotretinoína , Metronidazol/uso terapêutico
3.
Dermatol Clin ; 38(4): 429-439, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32892852

RESUMO

Granulomatous diseases are chronic inflammatory disorders whose pathogenesis is triggered by an array of infectious and noninfectious agents, and may be localized or a manifestation of systemic, disseminated disease. As in the skin, oral manifestations of granulomatous inflammation are often nonspecific in their clinical appearance. Thus, in the absence of overt foreign material or a recognizable infectious agent, identifying the underlying cause of the inflammation can be challenging. This article highlights various conditions known to induce granulomatous inflammation within the oral soft tissues.


Assuntos
Doença de Crohn/complicações , Granuloma/etiologia , Granuloma/patologia , Doenças da Boca/etiologia , Doença de Crohn/diagnóstico , Dermatite Perioral/etiologia , Dermatite Perioral/patologia , Granuloma de Corpo Estranho/patologia , Granulomatose com Poliangiite/complicações , Granulomatose com Poliangiite/diagnóstico , Granulomatose Orofacial/diagnóstico , Granulomatose Orofacial/terapia , Histoplasmose/complicações , Humanos , Doenças da Boca/patologia , Sarcoidose/complicações , Sarcoidose/diagnóstico , Sífilis/complicações , Tuberculose Bucal/complicações , Tuberculose Bucal/diagnóstico
8.
Clin Dermatol ; 34(3): 335-43, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27265071

RESUMO

A switch from cell-mediated to humoral immunity (helper T 1 [Th1] to helper T 2 [Th2] shift) during gestation plays a key role in placental immune tolerance. As a result, skin diseases that are Th2 mediated often worsen, whereas skin diseases that are Th1 mediated often improve during gestation. Also, due to fluctuations in glandular activity, skin diseases involving sebaceous and eccrine glands may flare, whereas those involving apocrine glands may improve during pregnancy. Despite these trends, inflammatory and glandular skin diseases do not always follow the predicted pattern, and courses are often diverse. We review the gestational course of inflammatory skin diseases, such as atopic dermatitis (atopic eruption of pregnancy), psoriasis, impetigo herpetiformis, urticaria, erythema annulare centrifugum, pityriasis rosea, sarcoidosis, Sweet syndrome, and erythema nodosum, as well as glandular skin diseases, including acne vulgaris, acne rosacea, perioral dermatitis, hidradenitis suppurativa, Fox-Fordyce disease, hyperhidrosis, and miliaria. For each of these diseases, we discuss the pathogenesis, clinical presentation, and management with special consideration for maternal and fetal safety.


Assuntos
Complicações na Gravidez/diagnóstico , Complicações na Gravidez/terapia , Dermatopatias/diagnóstico , Dermatopatias/terapia , Acne Vulgar/tratamento farmacológico , Acne Vulgar/etiologia , Dermatite Atópica/diagnóstico , Dermatite Atópica/tratamento farmacológico , Dermatite Perioral/etiologia , Eritema Nodoso/diagnóstico , Feminino , Doença de Fox-Fordyce/terapia , Hidradenite Supurativa/terapia , Humanos , Pitiríase Rósea/diagnóstico , Pitiríase Rósea/etiologia , Gravidez , Complicações na Gravidez/etiologia , Psoríase/complicações , Psoríase/terapia , Remissão Espontânea , Rosácea/terapia , Sarcoidose/complicações , Sarcoidose/tratamento farmacológico , Dermatopatias/etiologia , Síndrome de Sweet/diagnóstico , Exacerbação dos Sintomas , Urticária/tratamento farmacológico
9.
Clin Dermatol ; 33(6): 605-12, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26686012

RESUMO

Over the last ten years, there has been an increased awareness of allergic contact dermatitis (ACD) in children, in addition to adults. Historically, ACD was not considered a significant disease in the pediatric population. This may have been due to failure to employ patch testing, which is the gold standard for establishing a diagnosis of ACD. A number of epidemiologic studies now reflect upon the significance of positive patch tests in children and its utility in diagnosing ACD. While there is significant overlap among the most common allergens in children and adults, the patterns of exposure and sources of allergens can significantly differ, because children have distinct experiences related to their exposure to personal care products, articles of clothing, and time spent in play as opposed to work. Evaluation of the pediatric patient with dermatitis involves specialized knowledge in taking the pediatric history and specific techniques employed for successful patch test application.


Assuntos
Alérgenos/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/prevenção & controle , Dermatite Perioral/etiologia , Adolescente , Adulto , Fatores Etários , Nádegas , Criança , Pré-Escolar , Dermatoses do Pé/etiologia , Genitália , Dermatoses da Mão/etiologia , Humanos , Lactente , Dermatoses da Perna/etiologia , Anamnese , Testes do Emplastro , Coxa da Perna
12.
G Ital Dermatol Venereol ; 150(6): 741-4, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25058035

RESUMO

Skin manifestations, including scalded skin, desquamation, and chronic periorificial dermatitis, are rare clinical signs in patients with methylmalonic acidemia. This condition may be due to enzyme deficiency or multi-nutrient deficiency because of nutritional restriction. Bullous skin lesion is very rare in these patients and consequently, this type of skin lesion can be the presenting sign of methylmalonic acidemia.


Assuntos
Erros Inatos do Metabolismo dos Aminoácidos/complicações , Vesícula/etiologia , Queilite/etiologia , Dermatite Perioral/etiologia , Eritema/etiologia , Equilíbrio Ácido-Base , Erros Inatos do Metabolismo dos Aminoácidos/diagnóstico , Erros Inatos do Metabolismo dos Aminoácidos/tratamento farmacológico , Pré-Escolar , Consanguinidade , Feminino , Humanos , Lactente , Letargia/etiologia , Masculino , Vitamina B 12/uso terapêutico
13.
Am J Clin Dermatol ; 15(2): 101-13, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24623018

RESUMO

Perioral dermatitis is a common acneiform facial eruption found in both adults and children. Its variants are periorificial and granulomatous periorificial dermatitis. The etiology of perioral dermatitis remains unknown; however, topical corticosteroid use on the face commonly precedes the manifestation of this condition. There are an overwhelming number of treatment options for perioral dermatitis, and the options in children are slightly different from those in adults for both systemic medications and topical treatment. This article provides a literature review of the various applicable treatments available based on the level and quality of the evidence by the US Preventive Service Task Force. Oral tetracycline reveals the best valid evidence. However, if the patient is less than 8 years old, then this oral therapy may not be suitable. Topical metronidazole, erythromycin, and pimecrolimus also represent effective treatment choices with good evidence. Topical corticosteroid use is common in these cases and the question of whether it is a good treatment or a cause remains unanswered. Corticosteroid cream can improve the clinical picture, but there is a risk of rebound when treatment is stopped. We propose a treatment algorithm to assist dermatologists, pediatric dermatologists, and general practitioners encountering this condition.


Assuntos
Dermatite Perioral/terapia , Administração Oral , Administração Tópica , Algoritmos , Anti-Infecciosos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Dermatite Perioral/etiologia , Dermatite Perioral/patologia , Fármacos Dermatológicos/uso terapêutico , Diagnóstico Diferencial , Glucocorticoides/uso terapêutico , Humanos , Fotoquimioterapia
14.
Clin Dermatol ; 32(1): 131-40, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24314387

RESUMO

Physicians in various specialties-and dermatologists in particular-frequently encounter various forms of inflammation of the eyelids and of the anterior surface of the eye. Distinguishing the cause of itchy, painful, red, edematous eyelids is often difficult. Because the uppermost layer of the eyelids is part of the skin that wraps the entire body, almost every skin disease in the textbook can affect the periorbital area as well. In this contribution, we focused on the most common such disorders that require special consideration, as a result of their special appearance, their challenging diagnosis, or the nature of their treatment. We reviewed the key features of several common dermatides that affect the eyelids, such as atopic dermatitis, seborrheic dermatitis, allergic contact dermatitis, airborne contact dermatitis, rosacea, psoriasis, and others. We focused on the special clinical features, causes, and treatments specific to the delicate skin of the eyelids. Because structures of the eye itself (i.e., the conjunctiva, the cornea, the lens, and the retina) may be involved in some of the discussed periorbital skin diseases, we found it useful to add a brief summary of the eyelid complications of those diseases. We then briefly reviewed some acute sight-threatening and even life-threatening infections of the eyelids, although dermatologists are not likely to be the primary care physicians responsible for treating them.


Assuntos
Dermatite Atópica/complicações , Dermatite de Contato/complicações , Dermatite Perioral/etiologia , Doenças Palpebrais/diagnóstico , Doenças Palpebrais/etiologia , Celulite Orbitária/diagnóstico , Alérgenos/efeitos adversos , Blefarite/diagnóstico , Blefarite/etiologia , Blefarite/terapia , Soluções para Lentes de Contato/efeitos adversos , Dermatite Atópica/terapia , Doenças Palpebrais/terapia , Fasciite Necrosante/diagnóstico , Humanos , Soluções Oftálmicas/efeitos adversos , Psoríase/complicações , Psoríase/terapia
15.
Clin Dermatol ; 32(1): 125-30, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24314386

RESUMO

Perioral dermatitis is a relatively common inflammatory facial skin disorder that predominantly affects women. It is rarely diagnosed in children. A typical perioral dermatitis presentation involves the eruption of papules and pustules that may recur over weeks to months, occasionally with fine scales. The differential diagnosis includes seborrheic dermatitis, systemic lupus erythematosus, acne vulgaris, lupus miliaris disseminatus faciei, polymorphous light eruption, steroid-induced rosacea, granulomatous perioral dermatitis, contact dermatitis (allergic and irritant), and even basal cell carcinoma. The histopathology is similar to that of rosacea, with a perivascular and perifollicular lymphohistiocytic infiltrate and sebaceous hyperplasia. The etiology of perioral dermatitis is unknown, but the uncritical use of topical corticosteroids often precedes skin lesions. Physical sunscreens with high sun protection factors may cause perioral dermatitis in children.


Assuntos
Dermatite Perioral/diagnóstico , Dermatite Perioral/terapia , Corticosteroides/efeitos adversos , Dermatite Perioral/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino
16.
J Dermatolog Treat ; 25(6): 507-9, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23240905

RESUMO

BACKGROUND: The oral tetracyclines, especially minocycline hydrochloride, are often used as an effective treatment for perioral dermatitis; however, they are sometimes difficult to use, especially in children, because of the side effects. OBJECTIVE: The effectiveness of ß-lactam antibiotics was evaluated in three cases of perioral dermatitis. METHODS: Three Japanese patients with perioral dermatitis were treated with cefcapene pivoxil hydrochloride hydrate per os 100-300 mg/day. They were one girl (aged 10 years) and two adult women (aged 32 and 37 years respectively). One of the adult patients had a past history of Meniere's disease and the other had had a side effect, vertigo, from minocycline hydrochloride treatment. The presence of fusobacteria before and after the treatment was examined using the tape-stripping toluidine blue method. RESULTS: These patients showed the improvement in 1-2 weeks and were much improved or cured after 2-5 weeks. No side effects were found during the treatment. Fusobacteria were positive before treatment but became negative after the treatment in all of them. CONCLUSION: The ß-lactam antibiotics might be a useful treatment for perioral dermatitis, especially in cases who cannot take tetracyclines.


Assuntos
Antibacterianos/efeitos adversos , Cefalosporinas/efeitos adversos , Dermatite Perioral/tratamento farmacológico , Dermatite Perioral/etiologia , Infecções por Fusobacterium/tratamento farmacológico , beta-Lactamas/efeitos adversos , Administração Oral , Adulto , Antibacterianos/administração & dosagem , Cefalosporinas/administração & dosagem , Criança , Dermatite Perioral/microbiologia , Feminino , Humanos , Resultado do Tratamento , beta-Lactamas/administração & dosagem
20.
Eur J Dermatol ; 23(3): 303-7, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23568570

RESUMO

Cheilitis is a superficial inflammatory condition of the lip. It can occur either alone or be associated with stomatitis or perioral eczema. Contact hypersensitivity reactions are a frequent cause of cheilitis. Cosmetic and hygiene products are the most usual causes. Less frequently, allergic cheilitis is caused by contact with musical instruments, topical medicines or food allergens. Cases of cheilitis induced by dental material are rare and debated. The diagnosis relies on patch tests, which start with the European baseline series and the patient's personal cosmetic and topical products. This investigation will then be completed by the ingredients in the topical products and specific test series.


Assuntos
Queilite/diagnóstico , Queilite/etiologia , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Dermatite Perioral/diagnóstico , Dermatite Perioral/etiologia , Humanos
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