Perioral Dermatitis: Aetiology and Treatment With Tetracycline

Abstract

Summary.— “Perioral dermatitis” has been studied in 29 patients; all were females in their child‐bearing years, with ages ranging from 18 to 39 (mean 27). Twenty patients showed a marked flushing tendency, but the condition was apparently unrelated to other factors studied, including colouring, skin type, pregnancy and the contraceptive pill. Perioral dermatitis is a distinct entity and not a variant of seborrhoeic derma‐titis or rosacea. All patients were greatly improved by tetracycline therapy for 2–3 months, after which relapse was unusual.

Critical Appraisal of Reports on the Treatment of Perioral Dermatitis

“…We found 30 studies [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33] to contain at least partly appropriate information about the treatment of POD (table 3). The quality evaluation based on principles of evidence-based medicine [36] only revealed 2 studies with a medium-range score of 4 [5, 6] and the remaining 28 studies with scores between 0.5 and 2.5 (tables 1, 3) which we regarded to be of low quality.…”

“…According to the other randomised studies, 9% [5] and 18% [6] of the patients did not return for follow-up. The other papers received 1 point [12, 13, 18, 22,24,25,26, 29], 0.5 point [7,8,9,10,14,15,16,17,19,20,21, 23, 28, 30, 32, 33] or a score of 0 [11, 27, 31]. …”

“…A reasonable statistical analysis was not possible because of lack of pertinent data and the low level of evidence found in most papers [4,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33] and since the 2 papers with medium-range quality [5, 6] were different in several respects. …”

“…Up to February 2004, sources for this study were Medline (1964–2004), Embase (1966–2004), the Central Register of Controlled Clinical Trials (Central) of the Cochrane Library (1971–2004) and the 526 references of 3 textbook articles [1,2,3], the 30 papers cited in this study [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33] and 2 recent reviews [34, 35]. In Medline and Embase, 125 out of 215 and 296 out of 454 articles, respectively, were found referring to ‘perioral (and) dermatitis and therapy’.…”

Rationale for anti-inflammatory therapy in dry eye syndrome

“…Minocycline and doxycycline were found to inhibit angiogenesis induced by implanted tumors in rabbit cornea (73) . Tetracyclines have been used extensively to treat rosacea (74)(75)(76)(77) . Rosacea, including its ocular manifestations, is an inflammatory disorder, occurring mainly in adults with peak severity in the third and fourth decades.…”