DIFFERENTIAL DIAGNOSIS OF PERIORAL DERMATITIS BY MEANS OF DERMATOSCOPIC METHOD OF EXAMINING

Abstract

The diagnosis of perioral dermatitis is relatively easy to make in the presence of a typical clinical picture, characterized by the limited erythema around the mouth, at the background of which there are papules, micropapules, papulopustules and papulovesicles. However, in case of other rosacea-like dermatoses, such as rosacea and demodex folliculitis, difficulties can arise, especially in the presence of an atypical or a blurred clinical picture. Despite the fact that these diseases have a distinctive clinical picture and pathogenetic mechanisms, visible signs are similar, coincidence of some pathways of pathogenesis, as well as the problematical character of biopsy on the skin of the face in patients often complicate the diagnosis making. For this reason, great importance is attached to non-invasive diagnostic methods, dermatoscopic examination in particular. Despite the low magnification and resolution, this method makes it possible to assess the structure of the skin in a three-dimensional image over a sufficiently large area without damaging it. As a result of the dermatoscopic examination of 49 patients with perioral dermatitis and 54 patients with other rosacea-like dermatoses of the face (20 patients with erythematous-telangiectatic subtype of rosacea, 22 - with papulopustular rosacea subtype and 12 patients with demodicosis), the most significant for differential diagnosis dermatoscopic criteria of perioral dermatitis have been found: pink background due to the presence of erythema (69%), numerous pink micropapules (53%) and micropustules (31%), the presence of thin linearly tortuous vessels (39%) and minor follicular disorders (39%). The determined dermatoscopic features can be of a significant help in the differential diagnosis of perioral dermatitis from other dermatoses of the face.