Related Experiment Video

Updated: Jun 19, 2026

Resolving Water, Proteins, and Lipids from In Vivo Confocal Raman Spectra of Stratum Corneum through a Chemometric Approach
09:32

Resolving Water, Proteins, and Lipids from In Vivo Confocal Raman Spectra of Stratum Corneum through a Chemometric Approach

Published on: September 26, 2019

Steroid-induced periorificial dermatitis in children--clinical features and response to azelaic acid

Thomas Jansen1, Bodo C Melnik, Dirk Schadendorf

  • 1Department of Dermatology, Venereology and Allergology, University of Essen, Essen, Germany. thomas.jansen@medizin.uni-essen.de

Pediatric Dermatology
|October 7, 2009
PubMed

Insights

This study shows 20% azelaic acid cream effectively treats periorificial dermatitis in children. The treatment resolved skin lesions with minimal side effects and no recurrences observed.

Area of Science:

  • Dermatology
  • Pediatric Dermatology
  • Dermatologic Therapeutics

Background:

  • Periorificial dermatitis (POD) is a common facial rash, typically affecting young women, but occasionally seen in children.
  • Previous treatments for pediatric POD often involved topical corticosteroids, which may have adverse effects.
  • Understanding the clinical presentation, potential triggers, and effective treatments for pediatric POD is crucial.

Purpose of the Study:

  • To describe the clinical features of nongranulomatous periorificial dermatitis in children.
  • To investigate potential pathogenetic factors, including atopy and microbial colonization.
  • To evaluate the efficacy and safety of 20% azelaic acid cream in treating pediatric POD.

Main Methods:

  • A cohort of 10 children (aged 3-12) with POD underwent dermatologic examination and documentation of prior treatments.
  • All patients had a history of topical corticosteroid use on the face.
  • Diagnostic tests included skin prick tests, patch tests, and skin surface biopsies for microbial analysis (fungi, bacteria, Demodex). Patients were treated with 20% azelaic acid cream twice daily.

Main Results:

  • Periorificial dermatitis presented with typical morphology and distribution in all pediatric patients.
  • Half of the patients had atopy; however, allergy tests, bacterial/fungal cultures, and Demodex mite investigations were negative.
  • All 10 children achieved complete resolution of skin lesions within 4-8 weeks with 20% azelaic acid cream, with minimal and transient side effects.

Conclusions:

  • Topical corticosteroid use prior to onset was a common factor in pediatric POD.
  • 20% azelaic acid cream demonstrated high efficacy and a favorable safety profile for treating pediatric nongranulomatous periorificial dermatitis.
  • Azelaic acid cream offers a safe and effective alternative therapeutic option for children with this condition.

Related Concept Videos

Acne Infection01:27

Acne Infection

Acne is a multifactorial skin condition primarily affecting adolescents and young adults, with a global prevalence estimated to exceed 75% in this demographic. The condition is characterized by the formation of comedones (blackheads and whiteheads), papules, pustules, nodules, and, in severe cases, cysts, particularly in areas rich in sebaceous glands such as the face, neck, chest, and back. The pathogenesis involves increased sebum production, follicular hyperkeratinization, colonization by...
Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation. 
Skin Diseases and Disorders01:23

Skin Diseases and Disorders

Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
Antiasthma Drugs: Leukotriene Modifiers01:19

Antiasthma Drugs: Leukotriene Modifiers

Leukotriene modifiers, or cysteinyl leukotriene receptor antagonists, are medications used to manage chronic asthma. These agents target specific inflammatory mediators produced during arachidonic acid metabolism, an essential process in generating inflammation in the body.
Leukotriene modifiers work through two distinct mechanisms:
Clinical Applications of Epidermal Stem Cells01:19

Clinical Applications of Epidermal Stem Cells

Epidermal stem cells (EpiSCs) are mainly located at the basal layer of the epidermis. These cells repair minor injuries of the skin and replace dead skin cells. However, EpiSCs’ cannot heal severe wounds such as major burns or those from diabetes or hereditary disorders. In such cases, culturing the epidermal stem cells from the patient is possible and has yielded successful treatment options, such as laboratory-grown skin grafts. These grafts are synthesized using a patient’s own EpiSCs...
Staphylococcal Skin Infections01:29

Staphylococcal Skin Infections

Staphylococcus aureus is a Gram-positive coccus that resides harmlessly on the skin and mucous membranes of healthy individuals. When the skin barrier is breached, it can shift from a commensal to an opportunistic pathogen. This transition is facilitated by surface adhesins, such as clumping factor B and S. aureus surface protein G (SasG), which bind to structural proteins, including loricrin and cytokeratin, in the damaged epidermis. Protein A, another key factor, binds the Fc region of...