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