The etiology of perioral dermatitis is unknown, yet very often the uncritical use of topical steroids for minor skin alterations of the face precedes the manifestation of the disease. POD is limited to the skin. Although POD is limited to the skin and not life threatening, emotional problems may occur due to the disfiguring character of the facial lesions and a possible prolonged course of the disease. It is assumed that the number of male patients will increase because of changes in cosmetic habits. The vast majority of patients are younger women between 20-45 years old.
Subjective symptoms consist of a sensation of burning and tension.
Itching is rare. Skin lesions occur as grouped follicular reddish papules, papulovesicles and papulopustules on erythematous base with a possible confluent aspect. In an extreme variant of the disease, called lupus-like POD, granulomatous infiltrates occur with a yellowish aspect in diascopy. Fusiform spirilla bacteria, candida species and other fungi have been cultured from lesions without clear clinical relevance. Gastrointestinal disturbances such as malabsorption have been considered as well.