fluticasone and Dermatitis--Perioral

We present two patients with allergic rhinitis who developed perioral dermatitis (PD) after initiating intranasal steroid spray. Both patients had been previously misdiagnosed as having contact or seborrheic dermatitis, and therefore inappropriately and unsuccessfully treated with topical steroids. Physicians should be aware of this potential side effect of intranasal steroids to avoid incorrect therapeutic measures. In the setting of nasal steroids use, PD probably is an under-reported and commonly misdiagnosed condition that should be thought when a patient treated with nasal steroids present with small erythematous papules, papulovesicles, and papulopustules occurring against a background of redness, beginning in the nasolabial areas and spreading rapidly to the perioral zone.

Topics: Administration, Intranasal; Adolescent; Androstadienes; Anti-Allergic Agents; Child; Dermatitis, Perioral; Female; Fluticasone; Humans; Mometasone Furoate; Pregnadienediols; Rhinitis, Allergic, Perennial

Topics: Alleles; Androstadienes; Asthma; Bronchodilator Agents; Child, Preschool; Chromosomes, Human, Pair 7; Dermatitis, Perioral; DNA Mutational Analysis; Epilepsies, Myoclonic; Exocrine Pancreatic Insufficiency; Failure to Thrive; Female; Fluticasone; Humans; Infant; Male; Metered Dose Inhalers; NAV1.1 Voltage-Gated Sodium Channel; Status Epilepticus; Syndrome

Perioral dermatitis, also known as periorificial dermatitis, is characterized by a papular rash involving the perioral, perinasal and periorbital areas of the skin. There are multiple agents that may cause these lesions, with topical steroids being the most common. Inhaled steroids are rarely implicated as a cause of perioral dermatitis. Our case is illustrative because there was a clear association of perioral dermatitis with the use of inhaled steroids and a quick response to the treatment regimen, which included discontinuation of the offending agent.

Topics: Administration, Inhalation; Adolescent; Albuterol; Androstadienes; Anti-Asthmatic Agents; Asthma; Clindamycin; Dermatitis, Perioral; Drug Eruptions; Fluticasone; Humans; Male; Metronidazole; Salmeterol Xinafoate

Topics: Administration, Inhalation; Adrenal Cortex Hormones; Adult; Albuterol; Androstadienes; Dermatitis, Perioral; Drug Combinations; Drug Eruptions; Female; Fluticasone; Humans; Mouth; Powders; Salmeterol Xinafoate