Document Detail

Evidence based review of perioral dermatitis therapy.
MedLine Citation:
PMID:  20823788     Owner:  NLM     Status:  MEDLINE    
Perioral dermatitis presents as an eruption of erythematous papules, pustules and papulovesicles, most frequently seen in young women. Oral tetracyclines have been considered the first line treatment for years. However, recent publications have found newer agents to be efficacious. The authors performed a review of the available data in order to determine the strength of evidence supporting published therapies. A Pubmed and Cochrane Library database search for all cases, case series, and clinical trials dealing with the treatment of perioral dermatitis in English. Most cases of perioral dermatitis are self-limited, if the possible exacerbants of cosmetics and topical corticosteroids are discontinued ("zero therapy"). Many trials support the use of oral tetracyclines as a first line medication, as it significantly shortens the time to papule resolution. Topical erythromycin also reduces the time to resolution, but not as quickly. Topical pimecrolimus does not appear to decrease the time to complete resolution, but it does rapidly reduce the severity of the disease, particularly if prior corticosteroid use has occurred. The evidence supporting topical metronidazole, which is frequently used to treat perioral dermatitis in children, is relatively weak and supported only by case series and a trial showing it to be inferior to tetracycline. The evidence most strongly supports the efficacy of zero therapy, topical pimecrolimus, oral tetracycline, and topical erythromycin.
C S Hall; J Reichenberg
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Giornale italiano di dermatologia e venereologia : organo ufficiale, Società italiana di dermatologia e sifilografia     Volume:  145     ISSN:  0392-0488     ISO Abbreviation:  G Ital Dermatol Venereol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-09-08     Completed Date:  2011-01-06     Revised Date:  2012-07-30    
Medline Journal Info:
Nlm Unique ID:  8102852     Medline TA:  G Ital Dermatol Venereol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  433-44     Citation Subset:  IM    
Department of Dermatology, University of Texas Medical Branch, Austin, TX 78701, USA.
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MeSH Terms
Administration, Topical
Dermatitis, Perioral / drug therapy*
Erythromycin / administration & dosage
Evidence-Based Medicine*
Metronidazole / administration & dosage
Tetracycline / administration & dosage
Reg. No./Substance:
114-07-8/Erythromycin; 443-48-1/Metronidazole; 60-54-8/Tetracycline

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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