Photograph courtesy O. Dale Collins, MD
Seborrheic dermatitis is most common in adults, but an infantile form (ISD) is described. Some have called into question the true existence of an infantile form and suggest that other dermatoses including atopic dermatitis and psoriasis may confuse the clinical picture. A recent review of 87 children with presumed ISD found that approximately 34% went on to be diagnosed with classic atopic dermatitis [Peds Derm March 2014] suggesting a possible overlap or clinical spectrum.
The distribution of seborrheic dermatitis in an infant is somewhat different from that in an adult. The onset is from 2 weeks of age to 6 months. In one study, P. ovale was cultured from a high percentage of patients and not controls.
ISD is generally described as a red, scaly or crusty eruption in the so-called seborrheic areas, e.g. the groin, axilla, scalp, chest, pre auricular areas. The classic presentation in the groin is a red rash that involves the folds.
Ketoconazole cream may be applied BID. A daily bath with shampooing of the scalp and flexures is helpful. Hydrocortisone 1% cream or other mild steroid may be used to calm inflammation.
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