Answers to Dermatophile

ANSWER TO QUESTION 1 The answer is (d), perioral dermatitis. Perioral dermatitis is frequently confused with eczema, but it is a distinct diagnosis that can be caused by or worsen with topical steroid usage. The morphology of the lesions is similar to that found in rosacea, with small papulopustules or inflammatory papules in a perioral distribution. It may also involve the area around the nose and eyes, and then may be referred to as ‘periorificial dermatitis’. Treatment options include topical erythromycin or metronidazole; however, oral antibiotics with a tetracycline or macrolide appear to be much more effective. All topical corticosteroids (including over-the-counter preparations) should be discontinued.