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red spots, papule's around mouth, and small dry spots
Hi there,
About 5 months ago I developed a small pinkish spot under my lips on the right hand side. That spot multiplied in that area. After that I started to develop papule's and dry-like, red pimples with no head (just larger red bumps) around the mouth/jaw line.
Between the nose and mouth I had tiny bumps as well. I was told it was peri-oral dermatitis and was prescribed metronidazole gel for the area. I used that for about a week before it made the area worse.
My face slowly started to develop dry, pinkish skin around the sides of my nose, leading down to  my mouth. I was prescribed tetracycline but after taking it for a few days my skin got worse again! (the dryness didn't seem to be affected at all but my mouth/jaw area broke out a bit more).

The redness eventually went away on it's own somehow but I still had my mouth/jawline area to deal with.
I went to a dermatologist and he prescribed me doxycycline for a month a long with a mixture made of Clindamycin 2%, HC 1% in 80% H20 and 20% isopropanol to apply to the area.
This took away the red dots and a lot of the papule's (not all) but I seemed to get more of those red pimple-like bumps around my mouth while I was on it. Once I stopped both, the pinkish/red spots came right back but I developed a small red spot under my eye as well that spread just like the one under my mouth but I didn't exceed 2.

Right now, I have papule's all around my mouth, a long with a few red pimple-like bumps and that 1 tiny red spot under my eye. I also developed 2 small, dry, round patches on my forehead which is now spreading to a 3rd. I had the exact same patch on my upper right thigh and no matter what I put on it, would not go away. They look very similar to the dry patches I had around my nose earlier except smaller.

I haven't experienced any burning, itching, crusting, or oozing, just dryness on the dry patches. What is this? I've tried antibiotics, prescribed mixtures, gels... nothing has fully gotten rid of it.
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1 Answers
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1318109 tn?1292888573
Welcome to the Dermatology Expert Forum again!

It seems that lesions started spreading not only around your mouth and nose, but your eyes (under the eye, forehead) as well. It is typical of Periorificial (Perioral) dermatitis. However, facial papules, pustules and dry patches accompanied with redness that you mentioned, could be clinical manifestations of Rosacea (with possible extra facial localizations) too. If you decide to post photographs of your lesions, please, feel free to let me know. I will look at them and let you know what I see.

While perioral dermatitis is mostly a self-limiting disease that evolves during several weeks and resolves over several months (rarely longer), rosacea is a chronic disorder. Initial lesions and relapses can be triggered by psychological stress, sun exposure, spicy and/or hot foods and drinks, alcohol consumption, cosmetics, topical irritants, etc.

Rosacea is preferably treated locally with azalaic acid, metronidazole, sodium sulfacetamide or sulfur. Laser and IPL treatments are effective too but do not prevent relapses. If necessary, short-term oral therapy with tetracyclines could be prescribed. It is important to use broad spectrum sunscreen and avoid other risk factors too. For periorificial dermatitis, first line of therapy is topical metronidazole and oral tetracyclines for 2,5 – 3 months. Second line of topical therapy could be erythromycin, clindamycin, azalaic acid or sulfur preparations.

Use of corticosteroids is contraindicated in treatment of both diseases.

I hope all this help to give you an idea about possible diagnosis, clinical features and treatment options before you see your dermatologist. Please, try not to be upset with your situation (or anything else for that matter) as stress can contribute to further development of lesions.

Wishing You Optimal Health,
Dr. Jasmina Jankicevic
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