Diagnosis and Management of Common Dermatoses in Children: Atopic, Seborrheic, and Contact Dermatitis

Fleischer, Alan B.

doi:10.1177/0009922807309421

Cited by 20 publications

(8 citation statements)

References 96 publications

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“…Should simple shampooing prove ineffective, emollients such as warmed mineral or olive oil or white petrolatum are often applied to soften scales, followed by gentle removal with a soft hairbrush and shampooing. In severe or persistent cases, emollients in combination with medical treatments may be used, with reported topical medications including keratolytic agents like salicylic acid, anti-inflammatory agents such as low-potency steroids, antimycotics, for instance ketoconazole, and antibiotics [1, 12–14]. Gentle approaches will suffice to treat most infants with cradle cap, with non-medicated topicals serving as first-line treatment to facilitate removal of scales and reduce the need for medical treatments carrying potential risks, which is of particular importance in this age group.…”

Section: Introductionmentioning

confidence: 99%

Topical, Non-Medicated LOYON® in Facilitating the Removal of Scaling in Infants and Children with Cradle Cap: a Proof-of-Concept Pilot Study

Hengge

2014

Dermatol Ther (Heidelb)

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IntroductionCradle cap is a very common condition in infants that presents as greasy, scaly patches on the scalp within the first weeks of life. Although usually disappearing by itself, the condition worries parents because of its appearance. When removing the scales, it is crucial to prevent spot bleedings to avoid infections. The investigational medical device LOYON® (Cetiol® CC, dimethicone) solution (G. Pohl-Boskamp GmbH & Co. KG, Hohenlockstedt, Germany) has the potential to meet these needs since it removes scales gently. It was, therefore, the aim of this proof-of-concept study to assess the efficacy and safety of topically applied, non-medicated LOYON® in facilitating the removal of scaling in infants and children with cradle cap without inducing spot bleedings.MethodsThis single-center, open, proof-of-concept, pilot study was conducted in 20 male or female infants/children aged 3–36 months with clinically diagnosed cradle cap. The 8-day study period included one to three applications of LOYON®. Clinical assessment of scaling and secondary parameters was performed at baseline and after treatment. Adverse events were recorded. A questionnaire on subjective efficacy and usability was handed out to the parents.ResultsWith a maximum of three applications of LOYON® applied to 20 subjects, a reduction in scaling intensity from moderate or severe to very mild or mild was achieved in 80% of the subjects. Treatment success, defined as the reduction of the scaling baseline score by at least two points, was achieved in 50% of subjects. Results of this study do not indicate any safety concern. No spot bleedings were observed. LOYON® was generally well tolerated and overall treatment was rated as “good” by the parents/legal guardians.ConclusionThis study suggests that LOYON® is well tolerated, safe and effective in facilitating the removal of scaling in infants and children with cradle cap. With its gentle approach and rapid effect, LOYON® thus represents a good alternative to home remedies for treatment of cradle cap.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-014-0060-3) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Topical, Non-Medicated LOYON® in Facilitating the Removal of Scaling in Infants and Children with Cradle Cap: a Proof-of-Concept Pilot Study

Hengge

2014

Dermatol Ther (Heidelb)

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“…Seborrheic dermatitis of the flexural folds is uncommon in children and usually suggests immunodeficiency. 17 Skin biopsy may help differentiate seborrheic dermatitis from inverse psoriasis, with the former showing a "spongiform" appearance that is absent in psoriasis. 18 Inverse psoriasis demonstrates the typical psoriasiform reaction, including parakeratosis, epidermal hyperplasia, and elongation of rete ridges.…”

Section: Discussionmentioning

confidence: 99%

Resistant "Candidal Intertrigo": Could Inverse Psoriasis Be the True Culprit?

Wilmer

Hatch

2013

The Journal of the American Board of Family Medicine

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Inverse psoriasis is a disorder of intertriginous areas of the skin that can easily masquerade as candidal intertrigo. Candidal rashes are commonly encountered in primary care and typically respond promptly to therapy. When treatment fails, nonadherence to treatment and medication resistance often are suspected; however, the possibility of an incorrect diagnosis should also be entertained. This article presents the case of a patient with inverse psoriasis who was misdiagnosed with recurrent candidal intertrigo multiple times. The diagnosis and treatment of inverse psoriasis is reviewed, and other conditions that may be confused with Candida and inverse psoriasis, including bacterial intertrigo, tinea, and seborrheic dermatitis, are discussed. When confronted with a case of "resistant Candida," consideration of inverse psoriasis and other Candida mimics can allow physicians to diagnose and treat these conditions more effectively, avoiding the frustration experienced by our patient. A 68-year old woman with a history of poorly controlled type 2 diabetes mellitus presented as a new patient with exacerbation of chronic obstructive pulmonary disease (COPD) and a rash. The rash consisted of chronic, recurrent, erythematous patches in the inframammary and inguinal folds (Figure 1). The patches were mildly macerated. Scanty satellite lesions were observed near the inframammary but not the inguinal patches; scales were absent in these locations. There was scaling and tenderness in both auditory canals, with mild scaling of each pinna. Over the past week, the patient had applied multiple topical medications to the rash, including clotrimazole, moisturizer, and bacitracin/neomycin/polymyxin. She reported a 10-year history of similar rash affecting the axillae, groin, inframammary folds, retroauricular area, and gluteal cleft. The skin lesions had been diagnosed previously as candidiasis, but the patient was adamant that multiple trials with topical and oral antifungals did not help the rash. It is interesting that she noted that the skin lesions always improved when she was taking prednisone for the treatment of COPD exacerbations.The patient was prescribed prednisone for her COPD exacerbation and neomycin-polymyxin Bhydrocortisone otic solution for presumed otitis externa. Antifungal cream was offered but the patient was certain it would not help and insisted the prednisone would resolve the rash. She was instructed to discontinue all topical products for the rash and to return for follow-up. She presented 1 week later with a dramatic improvement in her rash. However, within 2 weeks of terminating oral prednisone, the erythematous patches recurred in the inframammary folds and gluteal cleft. The differential diagnosis included intertrigo, erythrasma, seborrheic dermatitis, inverse psoriasis, and resistant Candida secondary to poorly controlled diabetes. The affected areas were examined with a Wood's lamp and demonstrated no signs of fluorescence that would suggest erythrasma. A fungal culture was obtained, and clotrimazol...

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“…If these measures are not effective, ketoconazole 2% shampoo could be used until the condition resolves. 25,26…”

Section: Isdmentioning

confidence: 99%

An overview on seborrheic dermatitis and its treatment (allopathy and homeopathy)

Nagateja

Madhuri

et al. 2020

Int J Adv Med

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Seborrheic dermatitis is a common, chronic inflammation of the skin, characterized by the appearance of red, flaking, greasy areas of skin, most commonly on the scalp, nasolabial folds, ears, eyebrows and chest. The incidence of the disease has two peaks: one in newborn infants up to three months of age, and the other in adults of around 30-60years of age. The exact causes of seborrheic dermatitis are not completely understood, multiple factors appears to be involved in the pathophysiology of the disease. The principle three factors involved are: sebum secreted from sebaceous gland, presence of Malassezia yeast, and the immune response of the host. Currently allopathic treatment and prophylaxis regimens usually include antifungal agents, most often azoles, mild topical steroids, immunomodulatory activity of topical calcineurin inhibitors such as tacrolimus and pimecrolimus and other agents such as selenium sulfide, sulfur, metronidazole and coal tar. Homeopathy offers an excellent treatment for seborrheic dermatitis during all stages. Various homeopathic medicine used to treat seborrheic dermatitis are kali sulphuricum, thuja occidentalis, natrum muriaticum and more. The objective of this review is to discuss and provide information about seborrheic dermatitis and its epidemiology, etiology, pathogenesis, symptoms, diagnosis and its treatment in allopathy and homeopathy.

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Diagnosis and Management of Common Dermatoses in Children: Atopic, Seborrheic, and Contact Dermatitis

Cited by 20 publications

References 96 publications

Topical, Non-Medicated LOYON® in Facilitating the Removal of Scaling in Infants and Children with Cradle Cap: a Proof-of-Concept Pilot Study

Topical, Non-Medicated LOYON® in Facilitating the Removal of Scaling in Infants and Children with Cradle Cap: a Proof-of-Concept Pilot Study

Resistant "Candidal Intertrigo": Could Inverse Psoriasis Be the True Culprit?

An overview on seborrheic dermatitis and its treatment (allopathy and homeopathy)

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