Clinical Challenge: Scaling Dermatitis on the Scalp and Face - MPR

Clinical Challenge: Scaling Dermatitis on the Scalp and Face

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A 7-month-old Hispanic female child presents for evaluation of a scaling dermatitis of several weeks in duration that is affecting her scalp and face. She appears to be in good health otherwise and has no palpable lymph nodes or hepatosplenomegaly. Family history is negative for psoriasis and atopic dermatitis.

Infantile seborrheic dermatitis (ISD) is most commonly seen on the scalp and is also referred to as "cradle cap." It affects a significant proportion of newborns, although most have minimal involvement. Contributing factors include hyperseborrhea, Malassezia furfur, and inflammation.1 Children...

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Infantile seborrheic dermatitis (ISD) is most commonly seen on the scalp and is also referred to as “cradle cap.” It affects a significant proportion of newborns, although most have minimal involvement. Contributing factors include hyperseborrhea, Malassezia furfur, and inflammation.1 Children who develop ISD have a higher risk of developing atopic dermatitis.2

Differential diagnosis includes an exfoliative erythroderma, eczema, and sebopsoriasis. This is a benign self-limiting condition that usually resolves within 8 weeks. Daily shampooing and application of olive or mineral oil may help speed recovery. More severe cases respond to either hydrocortisone or ketoconazole creams.3

Rebecca Geiger, PA-C, is a physician assistant on staff at the DermDox Dermatology Center in Hazleton, Pennsylvania. Stephen Schleicher, MD, is an associate professor of medicine at the Commonwealth Medical College in Scranton, Pennsylvania, and an adjunct assistant professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

References

  1. 1. De Belilovsky C, Chadoutaud B, Msika P. Kerato-regulating care for infantile seborrheic dermatitis. J Am Acad Dermatol. 2008:58(Suppl 2):AB64.
  2. 2. Alexopoulos A, Kakourov T, Orfanou I, Xaidara A, Chrousos G. Retrospective analysis of the relationship between infantile seborrheic dermatitis and atopic dermatitis. Pediatr Dermatol. 2014;31:125-130.
  3. 3. Cohen S. Should we treat infantile seborrhoeic dermatitis with topical antifungals or topical steroids? Arch Dis Child.2004;89:288-289.