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Rosacea and Perioral Dermatitis


Authors: V. Slonková
Authors‘ workplace: I. dermatovenerologická klinika FN U sv. Anny v Brně a LF MU přednosta doc. MUDr. Vladimír Vašků, CSc.
Published in: Čes-slov Derm, 84, 2009, No. 4, p. 183-192
Category: Reviews (Continuing Medical Education)

Overview

Rosacea is a chronic inflammatory skin disease affecting mainly the central part of the face. Etiology has not been disclosed completely: inborn skin vascular homeostasis anomalies, degeneration of dermal matrix, UV light exposure or microorganism (Helicobacter pylori) influence has been hypothesised. Primary manifestations include flushing, persistent erythema, papules, pustules and teleangiectasia of the central part of the face. Secondary manifestations include burning, cutting pain, confluent inflammatory patches, eye involvement, phymatous changes, oedema and dry skin. Rosacea has following variants – erythematotelangiectatic, papulopustular, phymatous and ocular rosacea. Therapy includes elimination of triggers (usually alcohol, spicy food, UV exposure and stress), local therapy (metronidazole, azelaic acid, erythromycine, benzoyl peroxide, tretinoin, sulphur containing compounded products etc.) and systemic therapy (doxycycline, azithromycin, metronidazole, isotretinoin), physical methods (lasers, intense pulsed light, photodynamic therapy).

Perioral dermatitis is a chronic relapsing dermatosis. Most commonly it is caused by a long-term application of topical corticosteroids, excessive use of moisturizing creams in predisposed individuals with atopic diathesis, isopropyl myristate influence, UV radiation etc. Therapy is based on discontinuation of the causative agents – of topical corticosteroids, of any cosmetics, especially moisturizers. Topical therapy includes metronidazole, erythromycine, adapalen, azelaic acid in a non-fatty vehicle (gel, lotion). Serious cases might be treated with systemic antibiotics (doxycycline, minocycline, tetracycline, metronidazole). Prevention, i.e. minimal face topical corticosteroid application is very important.

Key words:
rosacea – perioral dermatitis


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Dermatology & STDs Paediatric dermatology & STDs
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