‘cradle cap’ in puppies?
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3. Miller WH, Griffin CE, Campbell LC. Congenital and hereditary
defects. In: Muller and Kirk’s Small Animal Dermatology. 7th edi-
tion. St Louis, MO: Elsevier, 2013; 593–597.
4. Gross TL, Ihrke PJ, Walder EJ et al. Dysplastic diseases of the ad-
nexae. In: Skin Diseases of the Dog and Cat: Clinical and Histo-
pathologic Diagnosis. 2nd edition. Oxford: Blackwell Publishing,
2005; 518–522.
5. Cerundolo R, Paradis M, Mecklenburg L. Breed specific canine
hair cycle abnormalities. In: Mecklenburg L, Linek M, Tobin DJ
eds. Hair Loss Disorders in Domestic Animals. Ames, IA:
Wiley-Blackwell, 2009; 169–175.
DOI: 10.1111/vde.12099
‘Cradle cap’ in puppies?
During the second year of her residency in dermatology,
my resident (M. D. Clark, personal communication, 2012)
asked me to look at a 5-week-old healthy male pitbull
dog. Whitish, mildly adherent scale was present on the
skin and in the hair coat over the rump and dorsal trunk.
The skin and hair coat were otherwise normal, and one of
the puppy’s seven littermates – also a male – was like-
wise affected. No diagnostic investigations or treatments
were performed, and the condition spontaneously
resolved over the course of 3 months in both puppies.
Flashback! During the first year of my residency in
medicine, my mentor (R. W. Kirk, personal communica-
tion, 1972) introduced me to my first puppy with what he
called ‘cradle cap’. The puppy was a healthy 6-week-old,
male basenji whose five littermates were unaffected.
White, mildly adherent scale was present on the skin and
in the hair coat over the rump (Figure 1). Areas of the hair
coat – with scale attached to the base of the hairs – were
clumped together and lifting off, revealing normal skin
and regrowing hair coat underneath. Skin scrapings, ace-
tate tape preparations and fungal culture were all nega-
tive. The puppy received no treatment, and the condition
spontaneously resolved over the course of 4 weeks.
Images of another puppy I examined with the identical
presentation in 1980 appear in the 6th edition of Muller &
Kirk’s Small Animal Dermatology (Figs. 14-2 and 14-3).1
This puppy was a healthy 5-week-old female, mixed
breed (Figure 2) whose three littermates were unaf-
fected. No diagnostic investigations or treatments were
performed, and the condition spontaneously resolved by
the time the puppy reached 3 months of age.
To my knowledge, the only reference to this canine
dermatosis appears in the classic textbook of Kr�al and
Schwartzman,2 wherein it is likened to ‘cradle cap’ in
human infants. However, the human condition appears to
be different.3 Adherent, yellow-brown, greasy scales,
crusts and inflammation are present on the scalp. In pup-
pies, greasy adherent scale crust and macroscopic inflam-
mation are not present and the rump is predominantly
affected. Histopathological findings in skin biopsies taken
from infants include spongiotic dermatitis with folliculo-
centric scale crust. Histopathological findings in affected
puppies have not been reported. The conditions are
benign and self-limited in both species.
In puppies, the presentation evokes a differential diag-
nosis of contact dermatitis (chemical or thermal), cheylet-
iellosis and pediculosis. However, no history of a
contactant is gathered, no ectoparasites are found, the
owners have not witnessed a prior dermatitis, and spon-
taneous resolution is the rule. The most useful tests that
might lead us to a better understanding of this condition
would be skin biopsies (for histopathology) and bacterial/
fungal cultures of early lesions. It will be difficult to con-
vince the owners of otherwise healthy puppies with a
Figure 1. Hairs over the rump are clumped together and have adher-
ent whitish scale at the base.
Figure 2. Clumped hairs and whitish scale are present over the
rump.
Correspondence: Danny W. Scott, Department of Clinical Sciences,
College of Veterinary Medicine, Cornell University, Ithaca, NY 14853,
USA. E-mail: dws11@cornell.edu
© 2013 ESVD and ACVD, Veterinary Dermatology, 25, 55–60.58
Letter to the Editor
spontaneously resolving condition to subject their pets to
such interventions.
The prevalence of canine ‘cradle cap’ is unknown. I sus-
pect that it is not rare, because veterinarians and dog
breeders I have spoken with over the years are aware of
the condition. Perhaps other colleagues will share their
comments about and experiences with this entity. We
need a better moniker than ‘cradle cap’… but I am hoping
to avoid ‘idiopathic, self-limiting, dorsally restricted kerati-
nization disorders of puppies’.
Sources of Funding
This study was self-funded.
Conflict of Interest
No conflicts of interest have been declared.
Danny W. Scott
Department of Clinical Sciences, College of Veterinary
Medicine, Cornell University, Ithaca, NY 14853, USA
References
1. Scott DW, Miller WH Jr, Griffin CE. Muller & Kirk’s Small Animal
Dermatology, 6th edition. Philadelphia: W.B. Saunders Co., 2001;
1003.
2. Kr�al F, Schwartzman RM. Veterinary and Comparative Dermatol-
ogy. Philadelphia: J.B. Lippincott, 1965; 175.
3. Collins CD, Hivnor C. Seborrheic dermatitis. In: Goldsmith LA,
Katz SI, Gilchrist BA et al. eds. Fitzpatrick’s Dermatology in
General Medicine, 8th edition. New York: McGraw-Hill, 2012;
259–266.
DOI: 10.1111/vde.12096
Atlas of Ear Diseases of the Dog and Cat 2013. Sue
Paterson, Karen Tobias. Wiley-Blackwell, Oxford, ISBN
1405193263. pp. 172; £69.99 (hardback)
When I was a student ear disease was taught by sur-
geons; the otitis lectures could be summarised as give
ear drops until they don’t work anymore and then do a
total ear canal ablation. Thankfully this situation soon
changed, as otitis was rightly brought into dermatology
with the recognition that most, if not all, cases were sec-
ondary to underlying conditions. There have been huge
advances in our understanding of ear disease, leading to
the discovery of new conditions, and the development of
new approaches to diagnosis and treatment. The advent
of new technologies, such as CT and MRI scans, video-
otoscopy, laser surgery and hearing tests has also been
hugely beneficial. Most recently, there has been a flower-
ing of collaboration between dermatologists and neurolo-
gists recognising that the middle ear is an important
interface between the skin and the nervous system. Nev-
ertheless, chronic and recurrent otitis remains a complex
problem where diagnosis and treatment can be frustrat-
ing for clinician and owner. There is therefore a need for a
text such as this to collate and present these advances in
knowledge for busy practitioners.
Sue Paterson is well known as a pioneer in the diagno-
sis and management of otitis, particularly in treatment
and hearing tests. Karen Tobias will be less familiar to
most dermatologists, but has an impressive pedigree as a
soft-tissue surgeon at the University of Tennessee
College of Veterinary Medicine with a long track record of
publications and presentations. Bringing together two
authors with such passion and experience in ear disease
has resulted in a clear and effective overview of otitis in
terms of dermatology, neurology and surgery.
The layout is conventional but logical, with an initial
chapter on the anatomy of the ear followed by subsequent
chapters on basic and advanced diagnostic techniques,
diseases of the pinna, ear canals, middle ear and inner ear,
and finally surgery including laser surgery. These provide a
comprehensive and up to date review of canine and feline
otitis with numerous aetiological updates as well as
new diseases, and novel approaches to diagnosis and
treatment. Bringing together dermatology, neurology and
surgery in one textbook is invaluable for clinicians.
The book is attractively produced. The text is well
written and reader-friendly, with great use of title fonts,
colour, tables and boxes. It is logically and clearly
divided into small units that help readability, especially
when looking for information quickly (when in the
middle of a clinic, for example). Full colour diagrams are
used to explain difficult concepts and are excellent. The
book is very well illustrated with many high quality
images, including some very good pictures of the ear
canal and middle ear. Both the diagrams and image are
alongside the relevant text, which helps the reader
understand and absorb information. There is an excel-
lent index, which enables specific information to be
found quickly. Finally, there is an e-book version for
those that prefer this format, although I haven’t had
chance to review this.
I have few criticisms, but these are minor. There are a
few minor typos and misplaced arrows, and some of the
images could do with more explanation. There are no
Book Review
© 2013 ESVD and ACVD, Veterinary Dermatology, 25, 55–60. 59
Letter to the Editor
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