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Prevalence of scalp scaling in prepubertal children.
Pediatrics. 2005 Jan; 115(1):e1-6.Ped

Abstract

OBJECTIVE

To determine the prevalence and most common etiologies of scalp scaling in infants and prepubertal children and the specificity of head and neck lymphadenopathy for the diagnosis of tinea capitis associated with scalp scaling.

DESIGN/METHODS

A cross-sectional study of 300 children, 200 from an urban general pediatric practice and 100 from 2 urban pediatric dermatology practices, was conducted. Half of the subjects were <2 years old, and half were 2 to 10 years old. Demographic data, medical history, and clinical data noting the presence of scalp scaling and other scalp signs and symptoms, as well as adenopathy of the head and neck, were collected.

RESULTS

Scalp scaling was seen in 66 (22%) children. There was an insignificantly higher prevalence of scalp scaling in those <2 years old compared with the 2- to 10-year-old group. In those <2 years old with scalp scaling, the most common diagnoses were seborrheic dermatitis (thick, adherent, greasy scale predominantly in the frontal and/or vertex areas of the scalp) and atopic dermatitis/eczema. Among those 2 to 10 years old with scalp scaling, the most common diagnoses were nonspecific (fine, white) scaling, seborrheic dermatitis, and atopic dermatitis/eczema. Nine (3%) patients were culture-positive for a dermatophyte, all of whom were black, and grew Trichophyton tonsurans. More than half (52.7%) of all patients had head and neck adenopathy. The presence of posterior nodes was significantly associated with atopic dermatitis/eczema and marginally associated with a positive dermatophyte culture. The presence of scalp scaling plus posterior adenopathy was significantly associated with seborrheic dermatitis and a positive dermatophyte culture in the entire study population and with atopic dermatitis in the pediatric dermatology clinics.

CONCLUSIONS

Scalp scaling was common in children 0 to 10 years old. Infantile-type seborrheic dermatitis was noted in both age groups: it was 3 times as likely in children <2 years old (18%) than in those 2 to 10 years old (6%). Contrary to traditional teaching, seborrheic dermatitis can be found in preadolescent children. Atopic dermatitis/eczema was associated with scalp scaling in both age groups. Head and neck adenopathy was very common and nonspecific for any 1 diagnosis. Posterior adenopathy with concurrent scalp scaling was significantly associated with seborrheic dermatitis, a positive dermatophyte culture, and atopic dermatitis. In this nonselected pediatric population, scalp scaling with adenopathy was not associated exclusively with tinea capitis.

Authors+Show Affiliations

Department of Pediatrics, Division of Dermatology, Children's Specialty Group, Children's Hospital of The King's Daughters, Eastern Virginia Medical School, Norfolk, VA 23507, USA. williajv@chkd.org <williajv@chkd.org>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15629960

Citation

Williams, Judith V., et al. "Prevalence of Scalp Scaling in Prepubertal Children." Pediatrics, vol. 115, no. 1, 2005, pp. e1-6.
Williams JV, Eichenfield LF, Burke BL, et al. Prevalence of scalp scaling in prepubertal children. Pediatrics. 2005;115(1):e1-6.
Williams, J. V., Eichenfield, L. F., Burke, B. L., Barnes-Eley, M., & Friedlander, S. F. (2005). Prevalence of scalp scaling in prepubertal children. Pediatrics, 115(1), e1-6.
Williams JV, et al. Prevalence of Scalp Scaling in Prepubertal Children. Pediatrics. 2005;115(1):e1-6. PubMed PMID: 15629960.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence of scalp scaling in prepubertal children. AU - Williams,Judith V, AU - Eichenfield,Lawrence F, AU - Burke,Bonnie L, AU - Barnes-Eley,Myra, AU - Friedlander,Sheila F, PY - 2005/1/5/pubmed PY - 2005/4/20/medline PY - 2005/1/5/entrez SP - e1 EP - 6 JF - Pediatrics JO - Pediatrics VL - 115 IS - 1 N2 - OBJECTIVE: To determine the prevalence and most common etiologies of scalp scaling in infants and prepubertal children and the specificity of head and neck lymphadenopathy for the diagnosis of tinea capitis associated with scalp scaling. DESIGN/METHODS: A cross-sectional study of 300 children, 200 from an urban general pediatric practice and 100 from 2 urban pediatric dermatology practices, was conducted. Half of the subjects were <2 years old, and half were 2 to 10 years old. Demographic data, medical history, and clinical data noting the presence of scalp scaling and other scalp signs and symptoms, as well as adenopathy of the head and neck, were collected. RESULTS: Scalp scaling was seen in 66 (22%) children. There was an insignificantly higher prevalence of scalp scaling in those <2 years old compared with the 2- to 10-year-old group. In those <2 years old with scalp scaling, the most common diagnoses were seborrheic dermatitis (thick, adherent, greasy scale predominantly in the frontal and/or vertex areas of the scalp) and atopic dermatitis/eczema. Among those 2 to 10 years old with scalp scaling, the most common diagnoses were nonspecific (fine, white) scaling, seborrheic dermatitis, and atopic dermatitis/eczema. Nine (3%) patients were culture-positive for a dermatophyte, all of whom were black, and grew Trichophyton tonsurans. More than half (52.7%) of all patients had head and neck adenopathy. The presence of posterior nodes was significantly associated with atopic dermatitis/eczema and marginally associated with a positive dermatophyte culture. The presence of scalp scaling plus posterior adenopathy was significantly associated with seborrheic dermatitis and a positive dermatophyte culture in the entire study population and with atopic dermatitis in the pediatric dermatology clinics. CONCLUSIONS: Scalp scaling was common in children 0 to 10 years old. Infantile-type seborrheic dermatitis was noted in both age groups: it was 3 times as likely in children <2 years old (18%) than in those 2 to 10 years old (6%). Contrary to traditional teaching, seborrheic dermatitis can be found in preadolescent children. Atopic dermatitis/eczema was associated with scalp scaling in both age groups. Head and neck adenopathy was very common and nonspecific for any 1 diagnosis. Posterior adenopathy with concurrent scalp scaling was significantly associated with seborrheic dermatitis, a positive dermatophyte culture, and atopic dermatitis. In this nonselected pediatric population, scalp scaling with adenopathy was not associated exclusively with tinea capitis. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/15629960/Prevalence_of_scalp_scaling_in_prepubertal_children_ DB - PRIME DP - Unbound Medicine ER -