__NOTOC__ Dermatosis neglecta is a skin condition in which accumulation of

sebum A sebaceous gland is a microscopic exocrine gland in the skin that opens into a hair follicle to secrete an oily or waxy matter, called sebum, which lubricates the hair and skin of mammals. In humans, sebaceous glands occur in the greatest nu ...

keratin Keratin () is one of a family of structural fibrous proteins also known as ''scleroproteins''. Alpha-keratin (α-keratin) is a type of keratin found in vertebrates. It is the key structural material making up scales, hair, nails, feathers, ho ...

, sweat, dirt and debris leads to a localized

patch Patch or Patches may refer to: Arts, entertainment and media * Patch Johnson, a fictional character from ''Days of Our Lives'' * Patch (''My Little Pony''), a toy * "Patches" (Dickey Lee song), 1962 * "Patches" (Chairmen of the Board song) ...

of skin discoloration or a wart-like plaque. It is caused by inadequate hygiene of a certain body part, usually due to some form of

disability Disability is the experience of any condition that makes it more difficult for a person to do certain activities or have equitable access within a given society. Disabilities may be Cognitive disability, cognitive, Developmental disability, dev ...

or a condition that is associated with

pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...

or increased sensitivity to touch (

hyperesthesia Hyperesthesia is a condition that involves an abnormal increase in sensitivity to stimuli of the sense. Stimuli of the senses can include sound that one hears, foods that one tastes, textures that one feels, and so forth. Increased touch sensitivi ...

) or immobility. Dermatosis neglecta typically develops several months after a disability or other affliction leads to improper cleaning. Patients may deny that negligence is the cause of the lesion, even though it completely resolves on vigorous rubbing with alcohol swabs or water and soap (which provides both diagnosis and treatment). Recognizing the diagnosis avoids unnecessary

skin biopsies Skin biopsy is a biopsy technique in which a skin lesion is removed to be sent to a pathologist to render a microscopic diagnosis. It is usually done under local anesthetic in a physician's office, and results are often available in 4 to 10 days. ...

Diagnosis

Differential diagnosis

Many other conditions can lead to localized

scaling Scaling may refer to: Science and technology Mathematics and physics * Scaling (geometry), a linear transformation that enlarges or diminishes objects * Scale invariance, a feature of objects or laws that do not change if scales of length, energ ...

hyperpigmentation Hyperpigmentation is the darkening of an area of skin or nails caused by increased melanin. Causes Hyperpigmentation can be caused by sun damage, inflammation, or other skin injuries, including those related to acne vulgaris.James, William; Ber ...

. This condition should firmly be distinguished from dermatitis artefacta, which is the '' factitious'' creation of a skin lesion, whereas dermatosis neglecta results from unconscious avoidance of cleaning due to pain or immobility. Other skin conditions which should not be mistaken for dermatosis neglecta include: terra firma-forme dermatosis (in which there is no history of inadequate cleaning); confluent and reticulated papillomatosis of Gougerot and Carteaud; several forms of ichthyosis; acanthosis nigricans; and Vagabond's disease.

History

The term was first coined by Poskitt and coworkers in 1995. Examples of case reports from the literature include a man who avoided washing the skin area surrounding an artificial pacemaker out of fear it might be damaged; a woman who didn't clean the right side of her chest due to hyperesthesia following an amputation for

breast cancer Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, milk rejection, fluid coming from the nipple, a newly inverted nipple, or a re ...

( mastectomy); a girl who was afraid to wash the area around an abdominal scar; and a man with multiple fractures, shoulder dislocation and radial nerve palsy which significantly reduced his mobility.

References

{{reflist Skin conditions resulting from physical factors