II. Epidemiology

  1. Begins in first month of life

III. Pathophysiology

  1. Idiopathic (Malassezia furfur Skin Infection, and hormonal changes have been considered)

IV. Symptoms

  1. No Pruritus (unlike in adults)

V. Signs

  1. Scalp (Cradle Cap)
    1. Diffuse or focal thick greasy Scaling and crusting dermatitis
    2. No weeping or oozing
  2. Face, Eyebrows, Neck, Retro-auricular, Axillae (flexural folds and intertriginous areas)
    1. Dry, scaly, erythematous Papules
    2. Non-pruritic
  3. Diaper involvement
    1. See Diaper Rash for differential diagnosis

VI. Associated Conditions

VII. Differential Diagnosis

  1. Atopic Dermatitis (contrast with onset in first month of a non-pruritic rash in Seborrhea)
  2. Langerhans Cell Histiocytosis
  3. Scabies
  4. Vitamin Deficiency
    1. Riboflavin deficiency
    2. Biotin Deficiency
    3. Pyridoxine Deficiency

VIII. Management: General Measures

  1. Be conservative as this is a benign condition that resolves spontaneously
    1. Measures listed below are purely cosmetic (do not alter course)
  2. Wet Compresses (Saline) to affected area
  3. Soft brush (e.g. ToothBrush) with Mineral Oil or petrolatum (e.g. vaseline) to remove scales from scalp
    1. May then wash with baby Shampoo
  4. Anti-seborrheic Shampoo (severe cases)
    1. Selenium Sulfide 1-2.5%
      1. Safety presumed but not established in infants
    2. Ketoconazole 2%
      1. Cream: apply to scalp 3 times weekly
      2. Shampoo: lather and rinse after 3 minutes, repeating 3 times weekly
      3. Brodell (1998) Pediatr Dermatol 15(5):406-7 +PMID:9796598 [PubMed]
  5. Other measures for inflammatory lesions
    1. Hydrocortisone 0.5 - 1%

IX. Course

  1. Self limited and resolves within first few months of life
  2. May persist in up to 8% of cases
    1. Mimouni (1995) J Pediatr 127: 744-6 [PubMed]

X. References

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Related Studies

Ontology: Seborrheic dermatitis of scalp (C0221244)

Definition (MSH) Excessive shedding of dry scaly material from the scalp in humans.
Concepts Disease or Syndrome (T047)
MSH D063807
ICD9 690.11
ICD10 L21.0
SnomedCT 28431005, 156327009, 77592001, 200763009, 48596006, 200764003, 201177005, 312211000009106, 400201008, 156329007
English Seb dermatitis of scalp, Seborrheic dermatitis of scalp, Seborrheic dermatitis (scalp), Seborrhea capitis [dup] (disorder), seborrheic dermatitis of scalp, seborrhea capitis, seborrhea capitis (diagnosis), seborrheic dermatitis of scalp (diagnosis), scalp seborrhea, dandruff, pityriasis capitis, Seborrhoeic dermatitis capitis, Seborrheic dermatitis capitis, Scurf, Dandruff, Seborrhoeic dermatitis of scalp (disorder), Seborrhea capitis (disorder), Seborrhoea sicca, Pityriasis sicca, Seborrhea sicca, Seborrhea sicca (disorder), Dandruff [Disease/Finding], Pityriasis capitis, Seborrhea capitis, Seborrheic eczema of scalp, Seborrhoeic dermatitis of scalp, Seborrhoeic eczema of scalp, Seborrhoea capitis, Pityriasis capitis (disorder), Seborrheic dermatitis of scalp (disorder), capitis; seborrhea, seborrhea; capitis, seborrhea; sicca, sicca; seborrhea, Seborrhoea capitis (disorder)
Japanese 頭部粃糠疹, トウブヒコウシン, 頭部脂漏, トウブシロウ, トウブシロウセイヒフエン, 頭部脂漏性皮膚炎
German Seborrhoea capitis, Seborrhoische Dermatitis capitis, Seborrhea capitis, Seborrhoe capitis, seborrhoische Dermatitis des Kopfes, Kopfschuppen, Schorf, Haarschuppen, Schuppen
Czech Lupy, Seboroická dermatitida na hlavě, Seborea hlavy, Seboroická dermatitida hlavy, Seborrhoea hlavy, lupy
Korean 두부지루
Hungarian Korpásodás, Seborrhoeás dermatitis a fejen, Seborrhoea capitis
Dutch seborrhoea capitis, seborroïsche dermatitis capitis, eczema seborrhoicum infantum, capitis; seborroe, seborroe; capitis, seborroe; sicca, sicca; seborroe, Seborrhoea capitis, hoofdroos
French Dermite séborrhéique du cuir chevelu, Dermite séborrhéique de la tête, Séborrhée de la tête, Séborrhée du cuir chevelu, Pellicules
Italian Seborrea del cuoio capelluto, Dermatite seborroica del cuoio capelluto, Dermatite seborroica del capo, Seborrea del capo, Desquamazione, Squama furfuracea, Forfora
Portuguese Dermatite seborreica da cabeça, Seborreia da cabeça, Caspa
Spanish Dermatitis seborreica capitis, Seborrea de la cabeza, seborrea seca, pitiriasis seca, seborrea del cuero cabelludo, pitiriasis de la cabeza, seborrea capitis, seborrea de la cabeza (trastorno), seborrea de la cabeza, caspa, seborrea seca (concepto no activo), Pityriasis capitis (trastorno), dermatitis seborreica de cuero cabelludo (trastorno), dermatitis seborreica de cuero cabelludo, Caspa, Pityriasis capitis

Ontology: Cradle cap (C0263233)

Concepts Disease or Syndrome (T047)
ICD10 L21.0
SnomedCT 247451002, 367121005, 62742006
Dutch melkschurft
French Casque séborrhéique
German Milchschorf
Italian Crosta lattea
Portuguese Crosta láctea
Spanish Gorro de lactante, costra de leche, costra láctea (trastorno), costra láctea
Japanese 乳痂, ニュウカ
Czech Cradle cap
English Cradle Cap, cradle cap, cap cradle, Cradle cap (finding), Cradle cap, Cradle cap (disorder)
Hungarian Koszmó