seborrhoeic_dermatitis_flashcards
What is Seborrhoeic Dermatitis?
A relatively common skin disorder seen in children
Which areas of the body are typically affected by Seborrhoeic Dermatitis in children?
The scalp (‘Cradle cap’), nappy area, face, and limb flexures
What is Cradle Cap?
An early sign of Seborrhoeic Dermatitis characterized by an erythematous rash with coarse yellow scales
When may Cradle Cap develop?
In the first few weeks of life
Describe the appearance of Cradle Cap.
An erythematous rash with coarse yellow scales
What is the first line of management for Seborrhoeic Dermatitis in children?
Reassurance that it doesn’t affect the baby and usually resolves within a few weeks
How can Cradle Cap be managed at home?
Massage a topical emollient onto the scalp to loosen scales, brush gently with a soft brush, and wash off with shampoo
What can be used if Seborrhoeic Dermatitis is severe or persistent?
A topical imidazole cream may be tried
By what age does Seborrhoeic Dermatitis in children usually resolve?
By around 8 months of age
summarise Seborrhoeic dermatitis in children
Seborrhoeic dermatitis in children
Seborrhoeic dermatitis is a relatively common skin disorder seen in children. It typically affects the scalp (‘Cradle cap’), nappy area, face and limb flexures.
Cradle cap is an early sign which may develop in the first few weeks of life. It is characterised by an erythematous rash with coarse yellow scales.
Management
reassurance that it doesn’t affect the baby and usually resolves within a few weeks
massage a topical emollient onto the scalp to loosen scales, brush gently with a soft brush and wash off with shampoo.
if severe/persistent a topical imidazole cream may be tried
Seborrhoeic dermatitis in children tends to resolve spontaneously by around 8 months of age.
A 5-week-old girl is brought to the GP surgery with a rash on her scalp:
What is the most appropriate management?
Referral to paediatric dermatologist
Swab rash and prescribe topical fusidic acid
Baby shampoo and baby oil
Topical hydrocortisone
Topical ketoconazole
Baby shampoo and baby oil
The correct answer is Baby shampoo and baby oil. The image provided shows a rash that is likely to be cradle cap (seborrhoeic dermatitis), which is a common condition in newborns. It typically presents as greasy, yellow scales on the scalp but can also affect the face, ears and neck. Management primarily involves gentle washing with baby shampoo followed by soft brushing to loosen scales, and application of baby oil or emollients to soften the scales. This approach is safe, simple and effective for most cases.
Referral to paediatric dermatologist would not be necessary in this case as cradle cap can usually be managed in primary care. Referral would only be needed if there was diagnostic uncertainty or if the rash was severe, unresponsive to treatment or associated with significant distress.
Taking a swab and prescribing topical fusidic acid would not be appropriate either. Fusidic acid is an antibiotic cream used for bacterial skin infections such as impetigo. Cradle cap is not caused by bacteria but by overactive sebaceous glands in the skin of newborn babies due to maternal hormones.
The use of topical hydrocortisone may help reduce inflammation and itching if present, but it’s not generally recommended as first-line treatment for cradle cap according to UK guidelines unless there’s significant inflammation which isn’t typical of cradle cap.
Lastly, topical ketoconazole, an antifungal medication, might be used in cases of seborrheic dermatitis in adults but it’s generally avoided in young infants due its potential side effects and lack of clear evidence of benefit at this age group.
