mometasone-furoate 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: Adrenal Cortex Hormones; Adult; Anti-Inflammatory Agents; Dermatitis, Perioral; Diagnosis, Differential; Female; Humans; Mometasone Furoate; Pregnadienediols; Substance-Related Disorders

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.

Topics: Administration, Cutaneous; Adolescent; Adult; Animals; Anti-Inflammatory Agents; Betamethasone; Case-Control Studies; Dermatitis, Perioral; Drug Administration Schedule; Female; Humans; Methylprednisolone; Middle Aged; Mites; Mometasone Furoate; Pregnadienediols; Prospective Studies

A case of vulval dermatitis and perioral dermatitis due to contact allergy to multiple class D corticosteroids, mometasone furoate and methylprednisolone aceponate is presented. Patch testing with commercially available corticosteroid creams is a simple and useful diagnostic test. Beware of delayed positive reaction, seen on day 8 of the repeat open application test on this patient.

Topics: Administration, Topical; Anti-Inflammatory Agents; Dermatitis, Allergic Contact; Dermatitis, Perioral; Diagnosis, Differential; Female; Glucocorticoids; Humans; Methylprednisolone; Middle Aged; Mometasone Furoate; Patch Tests; Pregnadienediols; Vulvar Diseases