Dermatosis Neglecta Involving Different Age Groups- A Series of Four Cases

Abstract

Dermatosis neglecta is a benign cutaneous condition which is often misdiagnosed. It occurs due to poor local hygiene or inadequate washing of a part of the body resulting in progressive accumulation of sebum, sweat, keratin and other debris which form an adherent crust of dirt. It mainly occurs in individuals who are unable to take care of themselves, like those with physical disability or psychosis. It is usually asymptomatic and is characterised by localised hyperpigmented patch or verrucous papules and plaques. Rubbing the affected area with alcohol-soaked gauze results in complete clearance of the lesion which is both diagnostic and therapeutic. The present case series describes four patients of different age groups. The first patient was a 65-year-old female, who underwent amputation of the gangrenous toes of right foot. She did not wash that leg for several weeks following surgery and developed cornflakes-like scaly lesions. Later lesions were diagnosed as dermatosis neglecta. Second case was an 18-year-old male, who presented with lesions on neck, which was misdiagnosed initially as Pityriasis vesicolor. The third patient was a 20-year-old female, who presented with lesions on neck and was earlier diagnosed and treated as acanthosis nigricans. The fourth patient was a two-year-old female who developed lesions on neck due to accumulation of dirt and debris. In all these patients, lesions resolved on rubbing with alcohol-soaked swab. Very little data is available in medical literature about this condition. Therefore this case series is being reported to bring awareness among dermatologists. This would enable prompt clinical recognition and obviate the need for expensive investigations and treatment strategies.

Keywords

• unwashed dermatosis
• diagnostic challenge
• poor local hygiene
• psychosis