Dermatologic Disorder, Case Study Example

Introduction

A 9 year old girl was broughtto a dermatologic clinic complaining of a burning, stinging sensation on the left face for more than a week. Upon examination there were numerous papules in the perioral, periocular, and perinasal regions of the left side face. The specialists took a history and conducted a physical before ordering some tests. After reviewing characteristics of the rash a biopsy was ordered to rule out similar conditions such as acne vulgaris; seborrhea dermatitis; allergic contact dermatitis; irritant contact dermatitis and rosacea (Kim, Woong Shin, & Suk Lee, 2011).

Body

Brief pathophysiology/epidemiology

Perioral dermatitis is also classified as‘childhood granulomatous periorificial dermatitis (CGPD), facial Afro-Caribbean childhood eruption (FACE)’ (Kim et.al, 2011, p. 386).  It is a peculiar granulomatous type of perioral dermatitis. Researchers have not been able to identify a cause for thecondition.  However, characteristically patients present with small monomorphous, papular eruptions mouth, nose and eyes region (Lipozencic & Ljubojevic, 2011).

Histopathological investigations reveal a distinct granulomatous pattern.Prepubescentchildren are mostly affected. There has been no predisposition variation between boys and girls.  Essentially, the condition can prolong for many months eventually resolving leaving no scars. This case study reported a 9 year-old girl presenting with discrete, multiple monomorphic, papular eruptions. This child’s parents gave a history of the condition existence for about 2-months. These eruptions were occurring inthe left perioral and periocular regions of the face. Histopathological examination revealed upper dermal and perifollicular granulomatous infiltration (Kim, et.al, 2011).

Treatment

Treatment for this condition is based on symptoms/signs presentation. Studies have revealed that medication may not be necessary for treating the irregularity. However, since patients and their relatives associate the condition with an infection they often force dermatologists to prescribe medications. The usual regime when medication is recommended consists of tetracycline antibiotics or erythromycin in children and pregnant women (Kanelleas Berth-Jones, J. 2010).

Further evaluations of treatmentefficacy conducted by Del Rosso (2011) reveled that other strategies can be used to relive itching and stinging sensations in the face. Rosso (2011) contends that many patients suffering from Perioral dermatitis are misdiagnosed for similar conditions and treated with corticosteroid. As such, he highly recommends ruling out similar manifestations before beginning a treatment regime. Treatment recommendations arepriming of the skin; selection of a topical therapy and selection of an oral therapy (Del Rosso, 2011).

Priming the skin involves combining the use of a mild nonmedicatedcleanser with a moisturizer before any topical medication is administered. It is suggested that priming the skin be undertaken at least three to five days prior to commencement of topical intervention. When idiopathic perioral dermatitis is diagnosed topical medications are not necessary since oral therapy alone is adequate enough for controlling the dysfunction (Del Rosso, 2011).

Metronidazole, azelaic acid, clindamycin (aqueous-based formulation), sulfacetamide 10% lotion, sulfacetamide 10%-sulfur 5% formulations, and calcineurin inhibitors’are the recommended topical application if needed.  The oral medications mentioned earlier in this section have been validated as being very effective in the oral therapeutic interventions forPerioral dermatitis(Del Rosso, 2011).

Conclusion

The foregoing case study journal article pertaining to perioral dermatitis presented a 9 year old child suffering from the dysfunction. In adults more women are affected than men.There are no gender predispositions. Scientists have discovered no causes for these eruptions, which resolve themselves after a while withouttreatment. When treatment is requested due to intolerable symptoms a regime consisting of skim priming; topical and oral therapies is adopted.

References

Del Rosso, J. (2011).Management of Papulopustular Rosacea and Perioral Dermatitis with Emphasis on Iatrogenic Causation or Exacerbation of Inflammatory Facial Dermatoses.

Kanelleas A, Berth-Jones J. (2010). Perioral dermatitis. Treatment of Skin Diseases: Comprehensive Therapeutic Strategies.(3rd ed). Philadelphia: Saunders-Elsevier.

Kim, Y.Woong Shin, J., & Suk Lee, J. (2011).  Childhood Granulomatous Periorificial Dermatitis.Ann Dermatol. 23(3): 386–388

Lipozencic, J., & Ljubojevic, S. (2011).  Perioral dermatitis. Clinics Dermatol. 2011;29:157–161.