Cradle cap and seborrheic dermatitis in infants
- Denis Sasseville, MD, FRCPC
Denis Sasseville, MD, FRCPC
- Professor of Dermatology and Research Coordinator, Division of Dermatology
- McGill University Health Centre
- Section Editors
- Moise L Levy, MD
Moise L Levy, MD
- Section Editor — Pediatric Dermatology
- Clinical Professor of Dermatology and Pediatrics
- Baylor College of Medicine
- Professor of Pediatrics and Medicine
- Dell Medical School/University of Texas, Austin
- Joseph Fowler, MD
Joseph Fowler, MD
- Section Editor — Dermatitis
- Clinical Professor of Dermatology
- University of Louisville School of Medicine
Seborrheic dermatitis is a self-limiting eruption consisting of erythematous plaques with greasy-looking, yellowish scales distributed on areas rich in sebaceous glands such as the scalp, the external ear, the center of the face, and the intertriginous areas.
This topic will discuss cradle cap and seborrheic dermatitis in infants. Seborrheic dermatitis in adolescents and adults is discussed separately. (See "Seborrheic dermatitis in adolescents and adults".)
Seborrheic dermatitis occurs in infants between the ages of 3 weeks and 12 months. It has been reported in about 10 percent of infants younger than one month . The prevalence peaks at the age of three months (about 70 percent) and decreases steadily in the following months, affecting about 7 percent of children aged one to two years .
The pathogenesis of infantile seborrheic dermatitis is not known. Transplacental transfer of maternal androgens stimulates the growth of the infant's sebaceous glands, which are necessary but not sufficient for the development of seborrheic dermatitis. The role of Malassezia, a lipid-dependent yeast, is not clear; Malassezia colonization has been reported in infants with seborrheic dermatitis, infants with other dermatologic conditions, and in normal infants [3-5].
The most common manifestation of seborrheic dermatitis in newborns and infants is "cradle cap," an asymptomatic and non-inflammatory accumulation of yellowish, greasy scales on the scalp (picture 1A-B). The vertex and the frontal area are commonly involved. Sometimes the eruption starts on the face, with erythematous, scaly, salmon-colored plaques (picture 2). The forehead, the retroauricular areas, eyebrows and eyelids, cheeks, and nasolabial folds are commonly affected (picture 3). Seborrheic dermatitis may also occur in the napkin (diaper) area (picture 4), on the trunk, with a predilection for the umbilical area, or in the intertriginous areas. It also may occur simultaneously at multiple sites (picture 5).
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