Periorol Dermatitis - Image DermIS

Periorol Dermatitis is a rosacea mimic and is considered in a differential diagnosis of rosacea. "Perioral” refers to the area around the mouth, and “dermatitis” indicates a rash or irritation of the skin. Usually Periorol Dermatitis is characterized by tiny red papules (bumps) around the mouth. The areas most affected by perioral dermatitis are the facial lines from the nose to the sides and borders of the lips, and the chin. The areas around the nose, eyes, and cheeks can also be affected. There are small red bumps, mild peeling, mild itching, and sometimes burning associated with perioral dermatitis. When the bumps are the most obvious feature, the disease can look like acne.

Compare images of acne, rosacea, perioral dermatitis and other similar rosacea mimics. DermIS 27 Images.

A research paper in 2004 said, "However, it remains disputed as to whether PD is an individual skin disease or a subtype of rosacea in atopic patients." source

A dermatologist diagnoses perioral dermatitis by examination. No other tests are usually done. Sometimes, scraping or a biopsy of the skin is done. Occasionally, blood tests are ordered to eliminate other conditions that can look similar. A culture for bacteria may sometimes be needed to eliminate the possibility of infection.

Perioral dermatitis is a facial rash that tends to occur around the mouth. Most often it is red and slightly scaly or bumpy. Any itching or burning is mild. It may spread up around the nose, and occasionally the eyes while avoiding the skin adjacent to the lips. It is more rare in men and children. Perioral dermatitis may come and go for months or years. One of the most common factors is prolonged use of topical steroid creams and inhaled prescription steroid sprays used in the nose and the mouth. Overuse of heavy face creams and moisturizers are another common factor. Other factors include skin irritations, fluorinated toothpastes, or other dental fluorinated products. Some dermatologists believe it is a form of rosacea or sunlight-worsened seborrheic dermatitis.

Why perioral dermatitis occurs more frequently in young women is a quandary. However, it may sporadically affect men. Its exact cause is unknown. Perioral dermatitis is a difficult condition to treat effectively, often requiring several months of treatment.

"...A low-potency topical steroid may also be used to suppress the inflammation and to wean off the strong steroid. Perioral dermatitis in childhood is probably a juvenile form of rosacea..." source

More on Steroids and Rosacea

More on Subtypes and Variants of Rosacea

Apparently the following study suggests that topical steroid use increases demodex mite density in perioral dermatitis

Density of Demodex folliculorum in perioral dermatitis.
Dolenc-Voljc M, Pohar M, Lunder T.
Department of Dermatovenereology, University Medical Centre Ljublana, Zaloska 2, SI-1525 Ljublana, Slovenia.

The role of Demodex folliculorum in perioral dermatitis is not satisfactory
explained. Our purpose was to assess the density of D. folliculorum in perioral dermatitis and evaluate the relationship of the mite count to previous therapy with topical steroids. A standardized skin surface biopsy of the chin was performed in 82 female patients with perioral dermatitis and in 70 control female subjects. Patients who received previous topical steroid therapy had a significantly higher mite density than the patients who had received no topical steroids (p<0.001). In the latter group of patients, the mite density did not differ significantly from that of the control group (p=0.629). Mite density increased significantly with the length of treatment with topical steroids (p<0.001). Our results suggest that increased density of D. folliculorum in perioral dermatitis is a secondary phenomenon, associated with topical steroid therapy.
source

"Tacrolimus ointment is increasingly used for anti-inflammatory treatment of sensitive areas such as the face, and recent observations indicate that the treatment is effective in steroid-aggravated rosacea and perioral dermatitis." source

"Perioral dermatitis was diagnosed in 329 patients....In 80 patients demodex was discovered....Treatment with liquid nitrogen gives good results..." source

Besides perioral dermatitis there are many other rosacea mimics.

Sources

AAD
Dermnet NZ
AOCD
MedlinePlus

Perioral dermatitis in children.
Laude TA, Salvemini JN.
Department of Dermatology, State University of New York, Health Science Center at Brooklyn, 11203, USA.

Epithelial barrier function and atopic diathesis in rosacea and perioral dermatitis.
Dirschka T, Tronnier H, Folster-Holst R.
Dermatological Practice Centre, Wuppertal, Germany 2004

Perioral dermatitis (rosacea-like dermatitis)--adverse effects of externally applied steroid preparations
Urabe H. - 1978

The treatment of steroid-induced rosacea and perioral dermatitis.
Sneddon IB. - 1976

Perioral dermatitis and rosacea-like dermatitis: clinical features and treatment.
Urabe H, Koda H. 1976

Rosacea-like dermatitis of the face. "Perioral dermatitis"
Steigleder GK, Strempel A. - 1968