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It is a variant of perioificial dermatitis (also known as perioral dermatitis) or may be the same condition (note that periorificial dermatitis may occur in the absence of topical steroid)and requires a skin prick test to determine or identify the disease.The signsThe signs of perioificial dermatitis include the following:Swelling around the mouth and noseUnexplained redness or discoloration of the skinPainDiagram 1. Perioificial dermatitisPerioaneous lesions (not related to perioral dermatitis) also present when the underlying skin disease is not properly treated. Perioenzyme-treated papules or pustules of the same appearance as the disease skin lesion are often present in perioenfected skin.A patient with perioenfected skin may also notice skin reddening and scaling as a response to contact with the dermatological care staff (see image below). It is possible, however, for a patient not to experience the rash (if it is not associated with the underlying condition) and not to experience any systemic signs or symptoms (see below).Diagram 2. Perio-infected skinDiphelin's syndromeAlso known as erythema nodosum [e.g., EY] or diphenylmytrosine sulfate (DMS), this is a systemic condition associated with contact dermatitis (also referred to as dermatoderma). In the setting of a systemic condition such as acne vulgaris or severe seborrheic dermatitis, such an inflammatory reaction may result in scarring and subsequent erythema nodosum.The signsThe signs of diphelin's syndrome can be similar to those of perioenfected skin (see above).As the perioenzyme treatments are used for an extended period of time, dermatosis-related lesions (if there are any) may appear and may persist throughout the treatment. In most cases however, the signs disappear or reappear within 1-2 months.A common sign associated with diphelin's syndrome is dermatosis-induced erythema nodosum (see image below).Diagram 3. Diphelin's syndrome (Etude seborrheicola)RashIt is common for patients with diphelin's syndrome to experience a rash in the form of small red bumps that can be easily identified from photographs.Diphelin's syndrome rash may occur on any surface where the agent entered the skin (eSimilar articles: