Which image shows perioral dermatitis?
Answers:
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.
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.
Note the golden yellow (often likened to honey) crusts that surmount the lesions. They tend to spread quickly.
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Comments
7 September 26
NTHABISENG ANNA MODIGA
Great learning tool on the differentials
4 September 26
Faiza
This is very helpful to analyze ourselves.
Thank you
4 September 26
Olufunmilayo
C
3 September 26
LK
Thanks for these emails! I find them a nice quick way to test and update my dermatology skills.
3 September 26
fahad
This was a very informative and easy to remember case, rather not a single case but 4 different yet similar looking cases.
Thankyou for making the understanding easier.
3 September 26
Dr Paul Anderson
Really good review
2 September 26
Deep
Classic appearance in C with sparing of vermillion border and lesions in the folds
2 September 26
Sam
Image A and D are both honey-crusted confluent of pustules ,but the latter spreads bilaterally whilst the former is only a unilateral lesion.This unilaterality also distinguishes it from D as Herpes lesions do not cross the mid-line because , histopathologically, the herpes virus reactivates inside a single nerve ganglion and travels down the specific neural fibre branch.
2 September 26
Andrea MUSCOLO
nella dermatite periorale in realta' si notano papule al cui apice ci sono vescicole/iniziali pustoline.Non sono vere e proprie papule!!!Se inizialmente non è bilaterale potrebbe confondersi con Herpes? (lasciamo da parte la sintomatologia)!
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