To the Editor.—
Since its description in 1957 by Frumess and Lewis as a "light-sensitive seborrheid," perioral dermatitis (PD) has continued to be a perplexing entity.1 Many causes have been postulated, including sunlight sensitivity, birth control pills, emotional stress, fluorinated steroid creams, Candida albicans, and rosacea. We have gathered clinical and historical data implicating fluoride dentifrices as an important etiologic factor in this dermatosis. The following two cases support this observation.
Report of Cases.—Case 1.—
A 63-year-old woman developed PD in mid-1971 that persisted for 24 months. There were exacerbations and remissions even though she was initially treated for one month with 0.025% fluocinolone acetonide cream and then intermittently with a mixture of 1% hydrocortisone, coal tar, and diiodohydroxyquin (Cor-Tar-Quin) and 250 mg of tetracycline hydrochloride four times a day. In August 1973, it was ascertained that she had been using a fluoride dentifrice for as long