Diagnostic dilemmas in pediatric/adolescent dermatology: scaly scalp

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

Introduction

Cradle 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.

Methods

This 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.

Results

With 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.

Conclusion

This 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 material

The online version of this article (doi:10.1007/s13555-014-0060-3) contains supplementary material, which is available to authorized users.

Effect of olive and sunflower seed oil on the adult skin barrier: implications for neonatal skin care

Natural oils are advocated and used throughout the world as part of neonatal skin care, but there is an absence of evidence to support this practice. The goal of the current study was to ascertain the effect of olive oil and sunflower seed oil on the biophysical properties of the skin. Nineteen adult volunteers with and without a history of atopic dermatitis were recruited into two randomized forearm-controlled mechanistic studies. The first cohort applied six drops of olive oil to one forearm twice daily for 5 weeks. The second cohort applied six drops of olive oil to one forearm and six drops of sunflower seed oil to the other twice daily for 4 weeks. The effect of the treatments was evaluated by determining stratum corneum integrity and cohesion, intercorneocyte cohesion, moisturization, skin-surface pH, and erythema. Topical application of olive oil for 4 weeks caused a significant reduction in stratum corneum integrity and induced mild erythema in volunteers with and without a history of atopic dermatitis. Sunflower seed oil preserved stratum corneum integrity, did not cause erythema, and improved hydration in the same volunteers. In contrast to sunflower seed oil, topical treatment with olive oil significantly damages the skin barrier, and therefore has the potential to promote the development of, and exacerbate existing, atopic dermatitis. The use of olive oil for the treatment of dry skin and infant massage should therefore be discouraged. These findings challenge the unfounded belief that all natural oils are beneficial for the skin and highlight the need for further research.

Escabiose na cabeça e pescoço: nós a estamos reconhecendo?

Apesar de o acometimento de cabeça e pescoço de crianças mais velhas e adultos na escabiose ser conhecido, a literatura é pobre em sua descrição. Estudados 124 pacientes com escabiose clássica com cinco anos de idade ou mais, para pesquisa, descrição e registro fotográfico das lesões de cabeça e pescoço. Esses locais foram acometidos em 35,8% dos casos, e as lesões mais encontradas foram crostas hemáticas, pápulas eritematosas com e sem escoriações ou crostas sobrepostas e descamação adjacente.