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Objective: To determine the prevalence and severity of prevalence rates and site and severity of seborrheic der-
seborrheic dermatitis and pityriasis capitis in Australian matitis and pityriasis capitis were measured.
preschool-aged children.
Results: The overall age- and sex-adjusted prevalence
Design: A stratified cross-sectional skin survey using of seborrheic dermatitis was 10.0% (95% confidence in-
cluster sampling of centers throughout Victoria, Aus- terval [CI], 8.2%-11.7%): 10.4% (95% CI, 7.8%-12.9%)
tralia. in boys and 9.5% (95% CI, 7.0%-12.0%) in girls. This was
highest in the first 3 months of life, decreasing rapidly
Setting: The study population included children at- by the age of 1 year, after which it slowly decreased over
tending child care centers, preschools, and Maternal and the next 4 years. Most (71.9%) had disease classified as
Child Health Centers, with the reference population being minimal to mild. Pityriasis capitis occurred in 41.7% (95%
Australian children 5 years and younger. CI, 38.8%-44.6%) of the 1116 children examined, with
85.8% categorized as minimal to mild only.
Participants: Of the 1634 children in the original sample,
1116 children aged 11 days to 5 years 11 months were Conclusions: Seborrheic dermatitis and pityriasis capi-
included in the study. tis are common in early childhood. Most children have
minimal to mild disease that would require little if any
Intervention: Parents completed a questionnaire re- treatment. Education programs directed at those caring
cording demographic information and personal and fam- for preschool-aged children are needed to provide infor-
ily history of skin problems and related diseases. A der- mation on simple preventative measures and treatment,
matologist performed a total skin examination, including if necessary, that could easily reduce the morbidity as-
the diaper area for children younger than 12 months. sociated with these very common conditions.
Main Outcome Measure: The age- and sex-specific Arch Dermatol. 2003;139:318-322
S
EBORRHEIC DERMATITIS and are no published data on the frequency of
pityriasis capitis (cradle cap) pityriasis capitis, but it has been sug-
are said to be common in in- gested that it may be a variant of sebor-
fancy and decrease in fre- rheic dermatitis.2
quency with increasing age. All studies on the frequency of cuta-
Nevertheless, there is some debate about neous conditions are dependent on reli-
the true nature or even existence of these able diagnostic criteria. In the case of seb-
conditions.1,2 Hence, their frequency in orrheic dermatitis and pityriasis capitis,
population-based studies is rarely re- there are no widely accepted clinical or
ported. In one study from the United other diagnostic criteria that are suffi-
States, a prevalence of 9.6 per 1000 per- ciently sensitive or specific to the condi-
sons aged 1 to 5 years was reported.3 In tions to be confident that what is being de-
pediatric clinics its relative frequency has scribed is uniquely seborrheic dermatitis
varied from 2.2% to 4.0% of all problems or pityriasis capitis.7
From the Department of
seen or 4.5% of problems seen in chil- When diagnostic criteria are deter-
Medicine (Dermatology),
The University of Melbourne, dren younger than 6 years.4,5 mined from patients seen in dermatology
St Vincent’s Hospital The major textbooks of dermatol- or pediatric clinics, they may be describ-
Melbourne, Fitzroy, Australia. ogy state that seborrheic dermatitis may ing only patients in whom the disease is
The authors have no relevant be common, but they frequently assert that biased toward the moderate to severe end
financial interest in this article. the true prevalence is unknown.2,6 There of the spectrum. Features of the very mild
Most children diagnosed on examination with sebor- This study demonstrates that seborrheic dermatitis and
rheic dermatitis and pityriasis capitis had disease that was pityriasis capitis are very common in young children, sup-