Challenge in diagnosis and management of periorificial dermatitis: A case report

Periorificial dermatitis is a disease that is rarely reported. Often misdiagnosed, periorificial dermatitis could affect periorificial area around the mouth, nose, eyes, and genitalia. Specific management needs to be considered because preferred therapy is not the same as other dermatitis. A 24-year-old female patient presented with itchy red patches around the eyes that had recurred over the past year. The patient had received several treatments but had not shown significant improvement. Previously diagnosed as irritant contact dermatitis, the patient's condition had worsened after receiving therapy. The diagnosis of periorificial dermatitis was then established and the patient received doxycycline 2x100 mg orally and topical clindamycin gel. Application of other topical agents was stopped, and the patient showed improvement. Periorificial dermatitis is a dermatitis that gets worsened by using topical steroids and other topical medications. Diagnosis is made clinically based on a complete anamnesis and physical examination. Treatment begins with zero therapy, which is the cessation of all topical agents used by the patient. Therapeutic choices include topical anti-inflammatory agents such as clindamycin or metronidazole gel, as well as oral doxycycline for more severe cases. Periorificial dermatitis must be distinguished from other dermatitis and requires specific treatment. Diagnosis and management of periorificial dermatitis become a challenge, especially for clinicians.