BACKGROUND: Two young patients with numerous flesh-coloured micropapular lesions involving the perioral and perinasal areas presented to us. In both cases the facial eruption had appeared during application of topical corticosteroids for a mild seborrhoeic dermatitis of the face. Histopathological examination revealed a sarcoid-like granulomatous reaction leading to a granulomatous perioral dermatitis. METHODS: We treated the first patient initially with minocycline 100 mg/day, but after 1 month and no improvement treatment with oral clarithromycin 250 mg/day was commenced for 6 weeks and then 125 mg/day for a further 2 months. The second patient began treatment with doxycycline 100 mg/day for 50 days and was then transferred to clarithromycin 250 mg/day for 10 days and then 250 mg on alternate days for 20 further days. RESULTS: In both patients, treatment with oral clarithromycin led to complete clearance of the facial eruptions. CONCLUSION: Clarithromycin is considered to be a useful alternative to tetracycline in the treatment of perioral granulomatous dermatitis.
- Perioral granulomatous dermatitis
- Sarcoid-like granuloma
- Topical corticosteroids
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