Management of Perioral Dermatitis

A 16 years old boy with a history of moderate atopic dermatitis involving the head/neck and asthma presents with pustules and itchy papules on the lower parts of his face (Figure). He has been using pimecrolimus cream on his face for AD, but the lesions keep getting worse. He recently started a new inhaler for his asthma. He denies any new skin care products. He has been moisturizing his face with a bland emollient (for which he has been using for the last 2 years). Which of the following is contributing to his skin findings?