DOI: https://doi.org/10.22263/2312-4156.2019.6.59
Adaskevich U.P., Miadzelets M.A.
Diagnosing of perioral dermatitis
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2019;18(6):59-67.
Abstract.
Perioral dermatitis (PD) is common chronic dermatosis of the face with the unclear etiology, which has various severity grades. To assess the severity of the disease, the perioral dermatitis severity index (PODSI) is used that provides a quantitative score of PD objective symptoms, namely erythema, papules, scaling. But at present, some other wide-spread objective signs of PD are revealed that should also be considered while assessing the PD severity grade.
The purpose of this study was to create a new index for assessing the PD severity grade with the most common manifestations of this disorder taken into account. Apart from that, we tried to determine most frequently observed statistically significant dermatoscopic signs of PD as compared with other facial dermatoses, as well as to study and compare dermatoscopic and histopathologic signs of a rare for our latitudes granulomatous form of PD.
Our study resulted in creating a new PD severity index that includes most common objective signs of this disorder (affected chin – 87%, erythema – 85%, unaffected zone around the lips – 91% and papules – 60%) and helps to determine the PD severity grade for each patient more exactly. Using statistical methods for investigation of dermatoscopic patterns in 49 patients with PD, 42 patients with rosacea and 12 patients with demodicosis, statistically significant dermatoscopic manifestations of PD were revealed: pink colour of the background (33%, р<0.001); micropapules (25%, р=0.000); absence of vascular abnormalities (27%, р=0.0013) or presence of thin tortuous vessels (16.5%, р=0.0000). It has been shown that the combined use of dermatoscopy and microscopy is a helpful and promising method for PD diagnosing.
Key words: index of perioral dermatitis, dermatoscopic signs, granulomatous perioral dermatitis.
References
1. Gromov MS, Grashkin VA. Diagnostic criteria, epidemiology and justification of clinical and pathogenetic types of perioral dermatitis. Voen-Med Zhurn. 2010;331(10):32-45. (In Russ.)
2. Rodionov AN. Dermatocosmetology. Facial skin lesions: diagnosis, treatment, prevention. Saint Petersburg, RF: Nauka i tekhnika; 2011. 912 р. (In Russ.)
3. Fitspatrik T, Dzhonson R, Vulf K, Polano M, Syurmond D. Dermatology: atlas-sprav: per s angl. Moskva, RF: Praktika; 1999. 1044 р. (In Russ.)
4. Lehmann P. Periorale Dermatitis. In: Plewig G, Kaudewitz P, Sander CA, ed. Fortschritte der praktischen Dermatologie und Venerologie. Vol 19. Berlin: Springer; 2005. P. 515-7.
5. Adaskevich VP. Acne vulgar and pink. Moscow, RF: Med kniga; Nizhny Novgorod, RF: Izd-vo NGMA; 2003. 160 р. (In Russ.)
6. Wollenberg A, Oppel Т. Scoring of skin lesions with the perioral dermatitis severity index (PODSI). Acta Derm Venereol. 2006;86(3):251-2. doi: http://dx.doi.org/10.2340/00015555-0044
7. Adaskevich VP. Perioral dermatitis: clinical presentation, diagnosis, treatment. Consilium medicum Dermatologiia. 2008;(1):17-20. (In Russ.)
8. Adaskevich VP. Acne and Rosacea. Saint Petersburg, RF: Ol'ga; 2000. 132 р. (In Russ.)
9. Pankratov VG, Revotyuk AA, Pankratov OV. Dermatoscopic picture of some common dermatoses. Med Novosti. 2011;(12):14-8. (In Russ.)
10. Lallas A, Argenziano G, Longo C, Moscarella E, Apalla Z, Koteli C, et al. Polygonal vessels of rosacea are highlighted by dermatoscopy. Int J Dermatol. 2014 May;53(5):e325-7. doi: http://dx.doi.org/10.1111/ijd.12270
11. Friedman P, Sabban EC, Cabo H. Usefulness of dermoscopy in the diagnosis and monitoring treatment of demodicidosis. Dermatol Pract Concept. 2017 Jan;7(1):35-38. doi: http://dx.doi.org/10.5826/dpc.0701a06
12. Myadelets OD, Adaskevich VP. Functional morphology and general skin pathology. Vitebsk, RB; 1997. 271 р. (In Russ.)
Information about authors:
Adaskevich U.P. – Doctor of Medical Sciences, professor, head of the Chair of Dermatovenereology, Vitebsk State Order of Peoples’ Friendship Medical University;
Miadzelets M.A. – lecture of the Chair of Dermatovenerology, Vitebsk State Order of Peoples’ Friendship Medical University.
Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Dermatovenereology. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Maryiana A. Miadzelets.