Neonatal seborrhoeic dermatitis
Background
- Also known as cradle cap, infantile seborrhoeic dermatitis, crusta lactea, milk crust, and honeycomb disease
- Starts between 2-6 weeks of life; improves by 6 months
- Malassezia furfur, non-contagious fungus
Clinical Features
- Greasy yellow-red scales
- Proclivity for scalp (cradlecap), but may find around ears, cheeks, neck
- Not pruritic
- Also axilla and groin where there are significant sebaceous glands
Differential Diagnosis
Neonatal Rashes
- Atopic dermatitis
- Diaper dermatitis
- Erythema toxicum neonatorum
- Neonatal acne
- Psoriasis
- Seborrheic dermatitis
- Tinea capitis
- Impetigo
- Contact dermatitis
- Perianal streptococcal dermatitis
- Milia
- Miliaria
- Mongolian spots
- Omphalitis
- Pustular melanosis
- Sucking blisters
Evaluation
- Clinical diagnosis
- Consider immunosuppression or HIV in severe or widespread lesions
Neonatal atopic dermatitis vs. seborrhoeic dermatitis
| Category | Neonatal atopic dermatitis | Neonatal seborrhoeic dermatitis |
| Presentation | 1-2 months | 2-6 months |
| Puritic (fussiness) | Yes | No |
Management
- Salicylic acid shampoo (Sebulex) OR
- Application of mineral oil followed by washing and removal of scales with comb
- Avoid topical steroids
Disposition
- Outpatient
See Also
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