Critical appraisal of reports on the treatment of perioral dermatitis.

Background: Presently, problems exist with the rationale of oral therapy and the nature and indication of topical and accompanying treatment of perioral dermatitis.

Objective: Providing the basis to overcome these problems by a quality evaluation of treatment reports and assessment of the consistency of treatment experience.

Methods: Sources were Medline (1964-2004), Embase (1966-2004), the Cochrane Central (1971-2004) and 526 references of 3 textbooks, 2 recent reviews and 30 papers on perioral dermatitis. Thirty English and German articles were selected. These studies were evaluated according to principles of evidence-based medicine and related criteria. Evaluation of 28 papers was carried out by the authors and of our own 2 papers by 2 other reviewers. Consistency of results was qualitatively assessed by the authors.

Results: There were only 2 therapeutic trials of medium-range quality. The other studies were of low quality. Consistency was noted concerning treatment with oral tetracycline (with 1 exception), discontinuation of topical corticosteroids and cosmetics and, to a lesser extent, regarding no therapy. There was inconsistency in respect to topical therapy.

Conclusion: The presented data help to interpret and conduct studies on the treatment of perioral dermatitis.