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A stinging and burning sensation with rash is often felt and noticed, but itching is less common. Often the rash is steroid responsive, initially improving with application of topical steroid. The redness caused by perioral dermatitis has been associated with variable level of depression.
Initially, there may be small pinpoint papule either side of the nostrils. Multiple small (1-2mm) papules and pustules then occur around the mouth, nose and sometimes cheeks. The area of skin directly adjacent to the lips, also called the vermillion border, is spared and looks normal. There may be some mild background redness and occasional scale. These areas of skin are felt to be drier and therefore there is a tendency to moisturise them more frequently. Hence, they do not tolerate drying agents well and the rash can be worsened by them.
Perioral dermatitis is also known by other names including rosacea-like dermatoses, periorofacial dermatitis and periorificial dermatitis.
Unlike rosacea which involves mainly the nose and cheeks, there is no telangiectasia in perioral dermatitis. Rosacea also has a tendency to be present in older people. Acne can be distinguished by the presence of comedones and by its wider distribution on the face and chest. There are no comedones in personal dermatitis.
Other skin diseases which may resemble perioral dermatitis include:
- Rosacea
- Acne vulgaris
- Seborrheic dermatitis
- Allergic contact dermatitis
- Irritant contact dermatitis
Dyshidrosis has been described as having the following characteristics:
- Itchiness of the palms or soles, followed the a sudden development of intensely itchy small blisters on the sides of the fingers, the palms or the feet.
- These blisters are often described as having a "tapioca pudding" appearance.
- After a few weeks, the small blisters eventually disappear as the top layer of skin falls off.
- These eruptions do not occur elsewhere on the body.
- The eruptions may be symmetrical.
Symptoms of miliaria include small red rashes, called papules, which are irritated and itchy. These may simultaneously occur at a number of areas on a sufferer's body, the most common including the upper chest, neck, elbow creases, under the breasts and under the scrotum. Other areas include skin folds, areas of the body that may rub against clothing, such as the back, chest, and stomach, etc. A related and sometimes simultaneous condition is folliculitis, where hair follicles become plugged with foreign matter, resulting in inflammation.
The symptoms relating to miliaria should not be confused with shingles as they can be very similar. Shingles will restrict itself to one side of the body but also has a rash-like appearance. It is also accompanied by a prickling sensation and pain throughout the region. Those who suspect they have shingles and not miliaria should seek medical advice immediately as the sooner antivirals are taken, the better.
Perioral dermatitis is a type of skin rash. Symptoms include multiple small (1–2 mm) bumps and blisters with sometimes background redness and scale, localized to the skin around the mouth and nostrils. Less commonly the eyes and genitalia may be involved. It can be persistent or recurring and resembles particularly rosacea and to some extent acne and allergic dermatitis. The term dermatitis is a misnomer because this is not an eczematous process.
The cause is unclear. Topical steroids are associated with the condition and moisturizers and cosmetics may contribute. The underlying mechanism may involve blockage of the skin surface followed by subsequent excessive growth of skin flora. Fluorinated toothpaste and some micro-organisms including candida may also worsen the condition, but their roles in this condition is unclear. It is considered a disease of the hair follicle with biopsy samples showing microscopic changes around the hair follicle. Diagnosis is based on symptoms.
Treatment is typically by stopping topical steroids, changing cosmetics, and in more severe cases, taking tetracyclines by mouth. Stopping steroids may initially worse the rash. The condition is estimated to affect 0.5-1% of people a year in the developed world. Up to 90% of those affected are women between the ages of 16 and 45 years, though it also affects children and the elderly, and has an increasing incidence in men.
Miliaria can be classified according to the top level at which obstruction occurs in the sweat glands.
Acneiform eruptions are a group of dermatoses including acne vulgaris, rosacea, folliculitis, and perioral dermatitis. Restated, acneiform eruptions are follicular eruptions characterized by papules and pustules resembling acne.
The hybrid term "acneiform", literally, refers to an appearance similar to acne.
The terminology used in this field can be complex, and occasionally contradictory. Some sources consider acne vulgaris part of the differential diagnosis for an acneiform eruption. Other sources classified acne vulgaris under acneiform eruption. MeSH explicitly excludes perioral dermatitis from the category of "acneiform eruptions", though it does group acneiform eruptions and perioral dermatitis together under "facial dermatoses".
Steroid acne is an adverse reaction to corticosteroids, and presents as small, firm follicular papules on the forehead, cheeks, and chest. Steroid acne presents with monomorphous pink paupules, as well as comedones, which may be indistinguishable from those of acne vulgaris. Steroid acne is commonly associated with endogenous or exogenous sources of androgen, drug therapy, or diabetes and is less commonly associated with HIV infection or Hodgkin's disease.
Irritant folliculitis is a cutaneous condition and usually occurs following the application of topical medications.
Dyshidrosis, is a type of dermatitis, that is characterized by itchy blisters on the palms of the hands and bottoms of the feet. Blisters are generally one to two millimeters in size and heal over three weeks. However, they often recur. Redness is not usually present. Repeated attacks may result in fissures and skin thickening.
The cause is unknown. Triggers may include allergens, physical or mental stress, frequent hand washing, or metals. Diagnosis is typically based on what it looks like and the symptoms. Allergy testing and culture may be done to rule out other problems. Other conditions that produce similar symptoms include pustular psoriasis and scabies.
Avoiding triggers may be useful as may a barrier cream. Treatment is generally with steroid cream. High strength steroid creams may be required for the first week or two. Antihistamines may be used to help with the itch. If this is not effective steroid pills, tacrolimus, or psoralen plus ultraviolet A (PUVA) may be tried.
About 1 in 2,000 people are affected in Sweden. Males and females appear to be affected equally. It explains about one in five cases of hand dermatitis. The first description was in 1873. The name comes from the word "dyshidrotic," meaning "difficult sweating," as problems with sweating was once believed to be the cause.
Bacterial skin infections include:
- Folliculitis is an infection of the hair follicle that can resemble pimples.
- Impetigo is a highly contagious bacterial skin infection most common among pre-school children. It is primarily caused by "Staphylococcus aureus", and sometimes by "Streptococcus pyogenes".
- Erysipelas is an acute streptococcus bacterial infection of the deep epidermis with lymphatic spread.
- Cellulitis is a diffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin. Cellulitis can be caused by normal skin flora or by exogenous bacteria, and often occurs where the skin has previously been broken: cracks in the skin, cuts, blisters, burns, insect bites, surgical wounds, intravenous drug injection or sites of intravenous catheter insertion. Skin on the face or lower legs is most commonly affected by this infection, though cellulitis can occur on any part of the body.
Most carbuncles, boils, and other cases of folliculitis develop from "Staphylococcus aureus".
Folliculitis starts with the introduction of a skin pathogen to a hair follicle. Hair follicles can also be damaged by friction from clothing, an insect bite, blockage of the follicle, shaving, or braids too tight and too close to the scalp. The damaged follicles are then infected by "Staphylococcus". Folliculitis can affect people of all ages.
Iron deficiency anemia is sometimes associated with chronic cases.
Infection of the skin is distinguished from dermatitis, which is inflammation of the skin, but a skin infection can result in skin inflammation. Skin inflammation due to skin infection is called "infective dermatitis."
Bacterial skin infections affected about 155 million people and cellulitis occurred in about 600 million people in 2013.
Folliculitis is the infection and inflammation of one or more hair follicles. The condition may occur anywhere on the skin except the palms of the hands and soles of the feet. The rash may appear as pimples that come to white tips on the face, chest, back, arms, legs, buttocks, and head.
Eosinophilic folliculitis (also known as "Eosinophilic pustular folliculitis" and "Sterile eosinophilic pustulosis") is an itchy rash with an unknown cause that is most common among individuals with HIV, though it can occur in HIV-negative individuals where it is known by the eponym Ofuji disease. EF consists of itchy red bumps (papules) centered on hair follicles and typically found on the upper body, sparing the abdomen and legs. The name eosinophilic folliculitis refers to the predominant immune cells associated with the disease (eosinophils) and the involvement of the hair follicles.
Eosinophilic pustular folliculitis of infancy (also known as "Eosinophilic pustular folliculitis in infancy," "Infantile eosinophilic pustular folliculitis," and "Neonatal eosinophilic pustular folliculitis") is a cutaneous condition characterized by recurrent pruritic crops of follicular vesiculopustular lesions.
Eosinophilic folliculitis associated with HIV infection typically affects individuals with advanced HIV and low T helper cell counts. It affects both men and women as well as children with HIV and is found throughout the world.
EF may also affect individuals with hematologic disease such as leukemia and lymphoma. It may also affect otherwise normal infants in a self-limited form. HIV-negative individuals can also develop EF — this is more common in Japan.
Feline acne is a problem seen in cats primarily involving the formation of blackheads accompanied by inflammation on the cat's chin and surrounding areas that can cause lesions, alopecia, and crusty sores. In many cases symptoms are mild and the disease does not require treatment. Mild cases will look like the cat has dirt on its chin, but the dirt will not brush off. More severe cases, however, may respond slowly to treatment and seriously detract from the health and appearance of the cat. Feline acne can affect cats of any age, sex or breed, although Persian cats are also likely to develop acne on the face and in the skin folds. This problem can happen once, be reoccurring, or even persistent throughout the cat's life.
Sebaceous glands are skin glands that produce oil and are mostly found in the skin of the chin, at the base of the tail, and in the eyelids, lips, prepuce, and scrotum. They are connected to hair follicles. In acne, the follicles become clogged with black sebaceous material, forming comedones (also known as blackheads). Comedones can become irritated, swollen, infected, and ultimately pustules. These may elicit itching and discomfort due to swelling and bacterial growth inside infected glands. Cats may continue to scratch and reopen wounds, allowing bacterial infections to grow worse. Bacterial folliculitis occurs when follicules become infected with "Staphylococcus aureus", and commonly associated with moderate-to-severe feline acne. Secondary fungal infections (species "malassezia") may also occur.
Other conditions that can cause similar-appearing conditions include skin mites, ringworm, yeast infection, or autoimmune diseases such as eosinophilic granuloma complex ("rodent ulcers"). These can be ruled out by a simple biopsy of affected cells.
Feline acne is one of the top five most common skin conditions that veterinarians treat.
Hot tub folliculitis (also known as "Pseudomonas aeruginosa" folliculitis) is a common type of folliculitis, a condition which causes inflammation of hair follicles.
This condition is caused by an infection of hair follicles due to the bacterium "Pseudomonas aeruginosa". The bacterium is commonly found in hot tubs, water slides, and such places. Children are more prone to this because they usually stay in the water longer than adults. Hot tub folliculitis appears on the skin in the form of a rash, roughly resembling chicken pox and then develops further to appear as a pimple. Hot tub folliculitis can be extremely painful and/or itchy, and left alone without scratching will go away much more quickly. If the rash is aggravated, it can stay, worsen, and spread, lasting for months. By that time, it is much more difficult to treat. The dots usually go away after about 7 to 10 days but the condition leaves a hyperpigmented lesion that goes away after a few months.
Normally, the rash does not need specific treatment and will go away on its own. Antibiotics may be prescribed in some cases. If the rash continues to appear longer than the 7- to 10-day time period, a physician should be consulted. Folliculitis that is not treated properly could worsen and cause abscesses.
Tinea barbæ (also known as "Barber's itch," "Ringworm of the beard," and "Tinea sycosis") is a fungal infection of the hair. Tinea barbae is due to a dermatophytic infection around the bearded area of men. Generally, the infection occurs as a follicular inflammation, or as a cutaneous granulomatous lesion, i.e. a chronic inflammatory reaction. It is one of the causes of Folliculitis. It is most common among agricultural workers, as the transmission is more common from animal-to-human than human-to-human. The most common causes are "Trichophyton mentagrophytes" and "T. verrucosum".
In both healthy and immunocompromised hosts, Majocchi's granuloma often presents as nodules and papules on areas that are most exposed to mechanical abuse—wear and tear—such as the upper and lower extremities. Patients will complain about papules, pustules, or even plaques and nodules at the site of infection. The papules will be pink-red and will be located in a perifollicular location. Hair shafts can be easily removed from the pustules and papules. Itching is also very common. Firm or fluctuant subcutaneous nodules or abscesses represent a second form of MG that is generally observed in immunosuppressed hosts. Nodules may develop in any hair-bearing part of the body but are most often observed on the forearms, hands, and legs of infected individuals. Involvement of the scalp and face is rarely observed. Lesions start as solitary or multiple well-circumscribed perifollicular papulopustules and nodules with or without background erythema and scaling. In rare circumstances, the lesions may have keloidal features.
Main symptoms that occur when affected with Tinea Barbae is pimple or blister amongst affected area, swelling and redness around infected area, red and lumpy skin on infected area. Crusting around hairs in infected area will occur, hairs on infected area will also be effortless to pull out. Tinea Barbae can be itchy or painful to touch but these symptoms do not always occur.
Superficial pustular folliculitis (also known as "Impetigo of Bockhart" and "Superficial folliculitis") is a superficial folliculitis with thin-walled pustules at the follicular openings.
Fungal folliculitis (also known as Majocchi granuloma) is a skin condition characterized by a deep, pustular type of tinea circinata resembling a carbuncle or kerion.
Tufted folliculitis presents with doll's hair-like bundling of follicular units, and is seen in a wide range of scarring conditions including chronic staphylococcal infection, chronic lupus erythematosus, lichen planopilaris, Graham-Little syndrome, folliculitis decalvans, acne keloidalis nuchae, immunobullous disorders, and dissecting cellulitis.
Pyoderma means any skin disease that is pyogenic (has pus). These include superficial bacterial infections such as impetigo, impetigo contagiosa, ecthyma, folliculitis, Bockhart's impetigo, furuncle, carbuncle, tropical ulcer, etc. Autoimmune conditions include pyoderma gangrenosum. Pyoderma affects more than 111 million children worldwide, making it one of the three most common skin disorders in children along with scabies and tinea.