Seborrhoeic dermatitis (infantile)

Infantile seborrhoeic dermatitis is an acute, erythematous scaling of scalp, nappy area, face, chest, back and limb flexures. Onset is usually within the first two weeks of life. The cause is unknown. There is no convincing evidence that it is related to adult seborrhoeic dermatitis.

Coarse, yellow scales on the scalp - cradle cap - are an early sign, with later spread to other areas. The infant is happy and untroubled, in contrast to the atopic infant who is irritable, feeds poorly, and distressed by itching.

Generalized seborrhoeic dermatitis is uncommon, but can occur in an otherwise healthy child. Infants should be evaluated for immunodeficiency if generalized disease occurs. Immunocompromised children with generalized seborrhoeic dermatitis often fail to thrive and have co-existing diarrhoea (Leiner's disease), and should be adequately evaluated (1).

Differential diagnosis includes tinea capitis, atopic dermatitis, and contact dermatitis (2)

Reference:

• (1) Schwartz RA, et al. Seborrheic dermatitis: an overview. AFP 2006;74(1):125-30
• (2) Naldi L, Rebora A. Seborrheic dermatitis. N Engl J Med.2009;360:387-396