Nothing to smile about
There is involvement of the perioral skin and the lips themselves. This distinguishes this condition from perioral rosacea where there is a thin line of sparing between involved skin and the vermilion border of the lip. This lady had been applying a topical steroid to the skin but the rash was primarily due to candida. Swabs grew this yeast and the rash cleared with some Hydrozole cream which is a mixture of 1% hydrocortisone cream and 1% clotrimazole. The weaker topical steroid helped to wean her skin from the stronger steroid she had used before and the clotrimazole dealt with the candida. It took three weeks for the rash to clear.
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