Dermatosis neglecta

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Dermatosis neglecta
A 35-year-old male, with multiple fractures, neurological deficit and immobility sustained in a fall, leading to the development of dermatosis neglecta of the left hand. Upper image: Dorsum of hand (at presentation). Lower image: Dorsum of hand (after two weeks).
SpecialtyDermatology

Dermatosis neglecta is a skin condition in which accumulation of

patch 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 or a condition that is associated with pain or increased sensitivity to touch (hyperesthesia) or immobility.[1]

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
.

Diagnosis

Differential diagnosis

Many other conditions can lead to localized scaling or hyperpigmentation.

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

Vagabond's disease
.

History

The term was first coined by Poskitt and coworkers in 1995.[3]

Examples of case reports from the literature include a man who avoided washing the skin area surrounding an

radial nerve palsy which significantly reduced his mobility.[1][4][5]

References