open access

Vol 9, No 3 (2023)
Case report
Published online: 2023-06-06
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Infantile seborrheic dermatitis differential diagnosis based on case report

Natalia Bień1, Maria Rajczak1, Klaudia Lipińska1, Joanna Narbutt2, Małgorzata Skibińska2, Aleksandra Lesiak2
·
Forum Dermatologicum 2023;9(3):123-125.
Affiliations
  1. Students’ Scientific Association of Experimental, Clinical and Surgical Dermatology, Medical University of Lodz, Poland
  2. Department of Dermatology, Paediatric and Oncological Dermatology, Medical University of Lodz, Poland

open access

Vol 9, No 3 (2023)
CASE STUDY
Published online: 2023-06-06

Abstract

Infantile seborrheic dermatitis often occurs during the first three months of life and most frequently presents as erythema and greasy scales located especially on the scalp (commonly called “cradle cap”). Usually, it is a mild, self-limiting condition. The severe, erythrodermic clinical appearance is rare and often demands differential diagnosis with other more serious skin conditions. We report a case of severe seborrheic dermatitis in an infant. A 5-weeks male infant presented with erythrodermic scaling lesions and exfoliation of the outermost layer of the epidermis, which had appeared after birth. Greasy scales were observed on the scalp, eyelids, and face accompanied by inflammation of the eyelids. Moreover, erythematous, well-demarcated lesions were noticed in the neck folds, behind the ears, in the axillary region, and diaper area. Considering the severe clinical appearance, additional tests such as skin biopsy and genetic analysis were performed to exclude other possible causes such as atopic dermatitis, Langerhans histiocytosis, congenital ichthyosis, and psoriasis. Based on clinical presentation and additional test results, infantile seborrheic dermatitis seemed to be the most probable diagnosis. The treatment including 1% tannic acid, 0.5% erythromycin eye cream, clotrimazole cream, hydrocortisone cream, and emollients was started in the hospital with a good response. After a month of therapy, the patient was re-admitted for the follow-up, with further improvement of the skin condition. It is essential to remember that the dermatoses that we should take into consideration during the differential diagnosis of severe infantile seborrheic dermatitis are atopic dermatitis, Langerhans histiocytosis, congenital ichthyosis, and psoriasis.

Abstract

Infantile seborrheic dermatitis often occurs during the first three months of life and most frequently presents as erythema and greasy scales located especially on the scalp (commonly called “cradle cap”). Usually, it is a mild, self-limiting condition. The severe, erythrodermic clinical appearance is rare and often demands differential diagnosis with other more serious skin conditions. We report a case of severe seborrheic dermatitis in an infant. A 5-weeks male infant presented with erythrodermic scaling lesions and exfoliation of the outermost layer of the epidermis, which had appeared after birth. Greasy scales were observed on the scalp, eyelids, and face accompanied by inflammation of the eyelids. Moreover, erythematous, well-demarcated lesions were noticed in the neck folds, behind the ears, in the axillary region, and diaper area. Considering the severe clinical appearance, additional tests such as skin biopsy and genetic analysis were performed to exclude other possible causes such as atopic dermatitis, Langerhans histiocytosis, congenital ichthyosis, and psoriasis. Based on clinical presentation and additional test results, infantile seborrheic dermatitis seemed to be the most probable diagnosis. The treatment including 1% tannic acid, 0.5% erythromycin eye cream, clotrimazole cream, hydrocortisone cream, and emollients was started in the hospital with a good response. After a month of therapy, the patient was re-admitted for the follow-up, with further improvement of the skin condition. It is essential to remember that the dermatoses that we should take into consideration during the differential diagnosis of severe infantile seborrheic dermatitis are atopic dermatitis, Langerhans histiocytosis, congenital ichthyosis, and psoriasis.

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Keywords

infantile seborrheic dermatitis, atopic dermatitis, Langerhans histiocytosis, congenital ichthyosis, psoriasis

About this article
Title

Infantile seborrheic dermatitis differential diagnosis based on case report

Journal

Forum Dermatologicum

Issue

Vol 9, No 3 (2023)

Article type

Case report

Pages

123-125

Published online

2023-06-06

Page views

387

Article views/downloads

231

DOI

10.5603/FD.a2023.0010

Bibliographic record

Forum Dermatologicum 2023;9(3):123-125.

Keywords

infantile seborrheic dermatitis
atopic dermatitis
Langerhans histiocytosis
congenital ichthyosis
psoriasis

Authors

Natalia Bień
Maria Rajczak
Klaudia Lipińska
Joanna Narbutt
Małgorzata Skibińska
Aleksandra Lesiak

References (11)
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  2. Foley P, Zuo Y, Plunkett A, et al. The frequency of common skin conditions in preschool-aged children in Australia: seborrheic dermatitis and pityriasis capitis (cradle cap). Arch Dermatol. 2003; 139(3): 318–322.
  3. Alexopoulos A, Kakourou T, Orfanou I, et al. Retrospective analysis of the relationship between infantile seborrheic dermatitis and atopic dermatitis. Pediatr Dermatol. 2014; 31(2): 125–130.
  4. Sarkar R, Garg VK. Erythroderma in children. Indian J Dermatol Venereol Leprol. 2010; 76(4): 341–347.
  5. Krooks J, Minkov M, Weatherall AG. Langerhans cell histiocytosis in children: History, classification, pathobiology, clinical manifestations, and prognosis. J Am Acad Dermatol. 2018; 78(6): 1035–1044.
  6. Fraitag S, Bodemer C. Neonatal erythroderma. Curr Opin Pediatr. 2010; 22(4): 438–444.
  7. Burden-Teh E, Thomas KS, Ratib S, et al. The epidemiology of childhood psoriasis: a scoping review. Br J Dermatol. 2016; 174(6): 1242–1257.
  8. Mahé E. Childhood psoriasis. Eur J Dermatol. 2016; 26(6): 537–548.
  9. Fölster-Holst R. Differential diagnoses of diaper dermatitis . Pediatr Dermatol. 2018; 35(Suppl 1): s10–s18.
  10. Lehman JS, Rahil AK. Congenital psoriasis: case report and literature review. Pediatr Dermatol. 2008; 25(3): 332–338.
  11. Sarkar R, Garg VK. Erythroderma in children. Indian J Dermatol Venereol Leprol. 2010; 76(4): 341–347.

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