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Which image shows perioral dermatitis?

 

 

 

 

Answers:

A= Herpes Simplex

Note the clustered vesicles which progress to crusts then erosions before healing. The unilateral distribution, clustering, and recurrence in the same location are the keys to the diagnosis.

B= Folliculitis

Folliculitis produces pustules and most commonly it is bacterial, with Staphylococci being the usual organism. Swabs can identify and indicate antibiotic sensitivity.

C= Perioral dermatitis

This is usually a symmetrical bilateral disease composed of red papules that spread around the mouth and into the nasolabial folds. They spare the immediate skin around the vermillion of the lips. There are often a few similar papules around the outer canthus of the eyes.

D= Perioral Impetigo

Note the golden yellow (often likened to honey) crusts that surmount the lesions. They tend to spread quickly.

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