PERIORAL DERMATITIS ASSOCIATED WITH THE USE OF IMMUNOSUPPRESSANT MEDICATIONS

Abstract

Introduction: Perioral dermatitis is a chronic inflammatory condition characterized by the appearance of erythematous papules around the mouth, which may extend to the nasal and ocular regions. Prolonged use of immunosuppressive drugs, especially topical corticosteroids and calcineurin inhibitors, has been associated with the development and worsening of this dermatosis. Objective: To analyze the relationship between the use of immunosuppressive drugs and the development of perioral dermatitis, evaluating risk factors, pathophysiological mechanisms and more effective therapeutic strategies. Methodology: The research was conducted based on the PRISMA checklist, using the PubMed, Scielo and Web of Science databases. The following descriptors were used: "perioral dermatitis", "topical immunosuppressants", "corticosteroids", "rebound effect" and "cutaneous microbiota". The inclusion criteria were studies published in the last 10 years, available in full text and specifically addressing the association between immunosuppressants and perioral dermatitis. Articles that were not available in full, narrative reviews without defined methodology and studies that exclusively involved pediatric populations were excluded. Results: The studies analyzed demonstrated that the continuous use of topical corticosteroids and calcineurin inhibitors altered the skin barrier, promoting inflammation and microbiota imbalance. The rebound effect after discontinuation of immunosuppressants was one of the main factors responsible for the worsening of the clinical picture. Conclusion: Perioral dermatitis associated with the use of immunosuppressants represents a significant clinical challenge due to its multifactorial etiology and the complexity of therapeutic management. The review highlighted the importance of early diagnosis and controlled discontinuation of immunosuppressants to prevent worsening of symptoms.