CRADLE CAP: A CLINICAL AND THERAPEUTIC ASSESSMENT IN IRAQI INFANTS

Background: Cradle cap is a common skin disorder that affects infants during the early weeks of life. It had been mentioned to be related to many other skin diseases like seborrheic dermatitis, psoriasis and atopic dermatitis. Objective: To shed a light on this disorder, its association to other skin diseases and to compare the therapeutic efficacy of a combined equal weights of flumethasone pivalate 0.02% cream and clotrimazole1% cream once daily with that of olive oil once daily too. Patients Methods: This is a case series descriptive and comparative therapeutic study conducted at the Department of Dermatology Venereology- Baghdad Teaching Hospital, during March 2007 and March 2008. Thirty two infants with cradle cap were involved in this study. They were divided randomly into 2 groups. Group I received a combined equal weights of flumethasone pivalate 0.02% cream and clotrimazole1% cream. Group II received olive oil. The parents instructed to apply the formula once overnight and wash the scalp at the morning and to continue the treatment till complete disappearance of the scales. Each infant was seen twice monthly till the age of 6 months. Results: Twenty four infants completed the study. Their ages ranged from 2 - 5 months with a mean ± SD of 3.167 ± 0.816 months. Fourteen (58.3%) infants were males and 10 (41.7%) were females. The age of onset of cradle cap was ranged from 1-3 months with a mean ± SD of 1.792 ± 0.550 months. The scale was greasy in 20 (83.33%), dry in 4 (16.66%), thick yellowish in 18 (75%) and thin whitish in 6 (25%). Twenty one (87.5%) of cases had infantile seborrhoeic dermatitis and three (12.5%) had infantile atopic dermatitis. All cases of atopic dermatitis had dry, thin and whitish scale. All (13) infants in group I showed clearance of the scale in duration ranging from 4 to 10 days with a mean ± SD of 7.15 ± 1.86 days. All (11) infants in group II showed clearance of cradle cap in a duration ranging from 6 to 15 days with a mean ± SD of 10.81 ± 2.40 days. There was a statistically significant difference between the 2 groups. P value = 0.0004. At the end of follow up the recurrence was higher among group1, but the difference was not significant P value = 0.8151. No side effects were reported from both treatment groups. Conclusion: Cradle cap is a common skin disorder among infants, most cases related to infantile seborrheic dermatitis and some had atopic dermatitis.