oral dermatitis presented as a dermatosis with localization around the mouth.This kind of dermatitis was first described in the United States in 1957.It denotes how seboreid persons with photosensitivity. In 1964, scientists had an offer called "oral dermatitis" because as noted its location on the face around the mouth with the characteristic clinical picture.The disease often strikes young women.
Debate about the nature of self-reliance with nosology oral dermatitis on the face.Many authors consider this type of dermatitis, one of the variants of seborrheic dermatitis or rosacea atypical form.Although other researchers believe that between these diseases and there are significant differences indicate that oral dermatitis is an independent disease, with well defined clinic.
oral dermatitis causes
principal value of oral dermatitis on the face is given to the effects on the skin face vserazlichnyh factors of external influence, including active cosmetics, detergents and t
but is believed to this day, the main cause of oral dermatitis on the face is unknown.Provocateurs can act potent corticosteroids, prolonged use of the outer route of administration, especially fluorine-containing medications (eg, toothpastes and creams).Such formulations may also act as a factor deteriorating later in the disease;also found no evidence for an association with such organisms as fuzimormnaya bacteria, candida, demodex mite, but there are indications of the disease with this type of bacteria in patients with immunnodefitsitnym state (AIDS, leukemia).But as pastes and ointments, which contain fluorine, is necessary to distinguish allergic contact reaction, which may take place orally dermatitis.It is also noted deterioration from contact with water, moisturizing cosmetics.
Recently believe that the occurrence of oral facial dermatitis is also associated with the use of ointments such as hydrocortisone, prednisolone, etc.Also, long-term use of foundation (in young girls in particular) can cause oral dermatitis.Ultraviolet radiation and weather conditions in some cases can also cause such dermatitis.
most important factor in the development of oral dermatitis on the face is the hormonal status in women who take hormonal contraceptives.Hormone creams (for example, with a rejuvenating effect, or in the treatment of eczema) may also contribute to the development of oral dermatitis.
fairly common oral dermatitis in children.It may also be caused by the use of corticosteroid creams and ointments, and cosmetic preparations.Chapping of the skin, especially when sucking nipples in the cold, can provoke the development of oral dermatitis in the infant.Dysbacteriosis intestinal microflora also plays a unique role in the development of oral dermatitis in children, and in general in the development of other types of dermatitis (seborrheic dermatitis, atopic dermatitis, allergic dermatitis, contact dermatitis).
after birth in infants may experience certain hormonal changes, due to the accumulation hormones during pregnancy, it can also manifest itself in the form of oral dermatitis, which usually resolves on its own within three to four weeks after birth.But this is not as common.
oral dermatitis symptoms
oral dermatitis affects mostly young women aged 20 to 35 years.Elderly women suffer less.But in males this kind of dermatosis is virtually absent, but the young guys can have oral dermatitis after treatment or the treatment of acne on the face, using steroid ointments.
Eruptions in oral dermatitis are localized more or less symmetrical arrangement in the nasolabial folds, chin, cheeks of neighboring areas, around the eyes, upper and lower lips.Small single lesions may occur on the bridge, at the temples, on the lateral portions of the cheeks.There are cases spread periorbital dermatitis oral localization process.There may be diffuse lesions of the whole face.
In the area affected by oral dermatitis, against diffuse or patchy erythema determined flat, hemispherical or conical papules, the location of which is presented in a haphazard way, sometimes grouping, but not draining.The size of the papules is from the head of a pin up to two centimeters.Color can be varied depending on the duration of the disease, from brown-red to bluish-red at an early stage, and light-brown during remission of the disease.Often, they can be converted into papullo-pustules or vesicles papullo-three weeks they disappear, and can leave a trace in the form of brownish spots, within which again may occur papules.
typical oral dermatitis is the presence of a narrow strip of free from red rash around the rim lips.In oral dermatitis arises comedones and rosacea, as there is no telangiectasia.The disease can occur with frequent exacerbations and remissions, that is wavy.In periods of relapse, patients may complain of slight burning, itching and scratching.Often marked worsening congestion and subjective sensations after taking alcoholic drinks, hot food, changes in temperature (wind, cold, heat, sun).Stability of dermatitis treatment, is often the cause of irritability and depressed mood in patients.But as a rule, the prognosis is favorable, with an average duration of the disease can vary from six months to five years.But there can be exceptions in the form of a rapid cure for the chronic course of the month and up to 10 years.
most authors also note nonspecific changes in skin cells (cell histology) in oral dermatitis.Typically, the dermis is observed vasodilation perifollicular and perivascular infiltration, which consists of histiocytes, lymphocytes, plasma cells and fibroblasts.
oral dermatitis in children in the early stages may manifest as skin redness around the mouth.Maybe invisible phenomenon, but the color of the skin will be flushed after a hot meal.As the disease redness of the skin becomes more stable and chronic, i.e. does not vanish.
In the absence of therapy, oral dermatitis in children, areas affected by them, begin to acquire bluish tint.Visual inspection is possible to see the expansion of the small capillary vessels.Later the skin may form small nodules and pustules.Perhaps the formation of roughness.The skin of the child eventually becomes more dense and coarse.It should be remembered that the presence of signs and symptoms in a child gives him a lot of discomfort, unpleasant, sometimes even pain.The child becomes irritable and tearful, constantly strives to scratch the irritated area.
oral dermatitis symptoms in children are more pronounced, so treatment should not delay, do not connect to a secondary infection or disease to develop into a chronic form.
oral dermatitis treatment
Without timely and reasonable treatment, oral dermatitis may stay months or even years.But, properly prescribed therapy generally may allow fast, high quality and permanently cure the rash in oral dermatitis.
first step is to stop taking steroids (the system that could impair the current and topical form of the drug).If the fluorochemical used for a long time of hard drugs, not to provoke a sharp lifting, say a temporary shift to a weak steroid without fluoride, with subsequent cancellation.
also necessary to restrict the contacting with water and irritating, moisturizing agents during treatment.
Antibiotics in most cases caused the greatest efficiency.They are used systemically, inside.For example: Doxycycline, JUnidoks Soljutab, Tetracycline, Minocycline is an average of 9-10 weeks, including the smooth and gradual decrease in the dosage of drugs in the last 3 weeks of treatment.
If you have an allergic reaction to tetracycline, in children under 8 years of age and nursing mothers are encouraged to nominate Erythromycin inside.
Very rarely, some patients may require subsequent maintenance therapy in certain doses of systemic antibiotics to control, or recurrence rates for several months, sometimes years.
Outdoor therapy may be administering concurrently with systemic treatment of antibiotics.But it can also be applied separately.It is also possible at the beginning of the treatment assignment only external medicines, but its insufficient effectiveness for treating oral dermatitis, can be added or replaced by use of systemic antibiotics.
peroral dermatitis Treatment may consist of a 0.75% metronidazole topically as a gel or cream (can only be used this drug in the lungs, oral dermatitis) twice a day (morning and evening);Erythromycin 2% in a cream or gel in the morning and evening;You can combine the two above stated the drug: metronidazole morning-evening-erythromycin.Can be used as an alternative to, Clindamycin topically, preparations which contain sulfur in the form of ointments, creams, azelaic acid.
There is evidence of a good topical calcineurin inhibitors (Elidel, Pimecrolimus, Tacrolimus, Prograf), but there are rare cases of granulomatous lesions after use of these drugs.Photodynamic therapy topically with 5-aminolevulinic acid has a good potential in the treatment of oral dermatitis on the face.
When the occurrence or suspected acute oral form of dermatitis in children must first show the child's pediatrician or dermatologist child.
First, you must determine the cause of the development of oral dermatitis.After determining the cause, you need to immediately eliminate the contact of the child with the stimulus.During treatment, the diet is very important in the treatment of children.An obligatory condition is considered to be an exception provoking allergens in food baby.It is also forbidden to overheat or supercool kid in the air, or at home.The need to limit direct sunlight.
important is the appointment of a multivitamin and mineral supplements during treatment, they should contain nicotinic acid and Ascorutin.Perhaps the single use of nicotinic acid in the form of injections, but they are usually very painful transferred to a child.Ascorutin can also be used as a standalone drug.
Drug treatment is oral dermatitis in children can only assign a specialist.In no event it is impossible to resort to self-medication.You can provoke deterioration of the child.The doctor may advise taking imidazole in therapeutic doses.
If a child joined and rash around the eyes, you should consult an eye specialist and a child, because the infection can give a strong development of complications to the eyes.
can at home to resort to traditional medicine in the form of a decoction of herbs (chamomile, oak bark, etc.) They contain flavonoids and active ingredients are able to give good relief from the overlaying of wet compresses to the affected area of the face, especially whenitching and anxiety in the child.