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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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Comments

  • S

    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.

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  • A

    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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