| Abstract [eng] |
Perioral dermatitis is an inflammatory skin condition characterized by small, 1-2 mm sized, grouped erythematous papules, papulovesicles, or papulopustules, with or without scales. The pathophysiology of this disease is not entirely clear, but it has been observed that impaired skin barrier function and signs of atopy are more common among perioral dermatitis patients. One of the main risk factors is the use of corticosteroids. In the literature, provoking factors such as infections, use of cosmetics and sunscreens, and various physical factors are also often mentioned as risk factors. Although perioral dermatitis most commonly occurs in women aged 16-45, the condition can also arise in children. Diagnosis usually requires classical clinical signs and a medical history. Perioral dermatitis is considered a benign, self-resolving skin condition that does not leave scars. Some patients recover without pharmacological treatment over several months, but for others, the condition may persist for several years. Treatment always begins with "zero therapy," and additionally, depending on the patient's age and the severity of the disease, topical or systemic medications may be prescribed. This paper describes a clinical case where corticosteroids prescribed for an 11-year-old patient with psoriasis provoked perioral dermatitis. Only long-term topical treatment combined with metronidazole, pimecrolime and zinc oxyde cream, along with a course of systemic doxycycline therapy, led to long- term remission of perioral dermatitis. This clinical case and the literature data discussed in the paper indicate the importance of considering possible side effects and pathologies when prescribing medication for psoriasis treatment, and when choosing the treatment strategy for perioral dermatitis, evaluating the patient's medical history, comorbidities, and informing the patient that treatment is long- term. |
