Answer to Last Month’s Online Challenge
Infantile seborrhea has many of the features of the other papulosquamous conditions listed, but the diagnosis is most commonly clinically evident on examination alone. If you are unsure, a KOH preparation will quickly sort out the dermatophytes. Also, the lack of itch makes atopic dermatitis very unlikely.
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DISCUSSION: Option C, Seborrhea, is the correct answer.
Infantile seborrhea has many of the features of the other papulosquamous conditions listed, but the diagnosis is most commonly clinically evident on examination alone. If you are unsure, a KOH preparation will quickly sort out the dermatophytes. Also, the lack of itch makes atopic dermatitis very unlikely.
The difficulty arises in excluding psoriasis. Many consultants consider that there is significant overlap between seborrhea and psoriasis because many children with seborrhea also have features of psoriasis. I like to reserve my final thoughts; I am not comfortable excluding psoriasis until I have seen a rapid response to therapy, and until I see that this response continues if the condition recurs.
Pityrosporum ovale-yeast commonly found as part of the skin's normal microflora-is the most likely cause of this condition. There are a number of immunologic and biochemical theories to explain individual susceptibility or causation but, for the clinician, the often rapid and complete response to topical azoles is strong evidence that this organism plays a significant role in the etiology.
Lawrence Eichenfield, MD, talks tapinarof cream, 1%, nemolizumab FDA approvals for atopic dermatitis
December 20th 2024"Tapinarof comes in with that mixture of the short-term studies and longer-term studies intermittently, giving us a nice, effective alternative non-steroid for eczema across the ages."
Recognize & Refer: Hemangiomas in pediatrics
July 17th 2019Contemporary Pediatrics sits down exclusively with Sheila Fallon Friedlander, MD, a professor dermatology and pediatrics, to discuss the one key condition for which she believes community pediatricians should be especially aware-hemangiomas.
