Dermatosis neglecta

# Overview
Dermatosis neglecta is a skin condition in which accumulation of sebum, keratin, sweat, dirt and debris leads to a localized 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.
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.
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 (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.

# 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 (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.

# Dignosis

## Physical Examination

### Skin
- Dermatosis neglecta. Adapted from Dermatology Atlas.
- Dermatosis neglecta. Adapted from Dermatology Atlas.
- Dermatosis neglecta. Adapted from Dermatology Atlas.
- Dermatosis neglecta. Adapted from Dermatology Atlas.
- Dermatosis neglecta. Adapted from Dermatology Atlas.

# Footnotes
-  Jump up to: 1.0 1.1 Ruiz-Maldonado R, Duran-McKinster C, Tamayo-Sanchez L, Orozco-Covarrubias ML (June 1999). "Dermatosis neglecta: dirt crusts simulating verrucous nevi". Arch Dermatol. 135 (6): 7289. doi:10.1001/archderm.135.6.728. PMID 10376717.CS1 maint: Multiple names: authors list (link) .mw-parser-output cite.citation{font-style:inherit}.mw-parser-output q{quotes:"\"""\"""'""'"}.mw-parser-output code.cs1-code{color:inherit;background:inherit;border:inherit;padding:inherit}.mw-parser-output .cs1-lock-free a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-limited a,.mw-parser-output .cs1-lock-registration a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-lock-subscription a{background:url("")no-repeat;background-position:right .1em center}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration{color:#555}.mw-parser-output .cs1-subscription span,.mw-parser-output .cs1-registration span{border-bottom:1px dotted;cursor:help}.mw-parser-output .cs1-hidden-error{display:none;font-size:100%}.mw-parser-output .cs1-visible-error{display:none;font-size:100%}.mw-parser-output .cs1-subscription,.mw-parser-output .cs1-registration,.mw-parser-output .cs1-format{font-size:95%}.mw-parser-output .cs1-kern-left,.mw-parser-output .cs1-kern-wl-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right,.mw-parser-output .cs1-kern-wl-right{padding-right:0.2em}
-  Qadir SN, Ejaz A, Raza N (2008). "Dermatosis neglecta in a case of multiple fractures, shoulder dislocation and radial nerve palsy in a 35-year-old man: a case report". J Med Case Reports. 2 (1): 347. doi:10.1186/1752-1947-2-347. PMC 2596164. PMID 19014627.CS1 maint: Multiple names: authors list (link)
-  Lucas JL, Brodell RT, Feldman SR (2006). "Dermatosis neglecta: a series of case reports and review of other dirty-appearing dermatoses". Dermatol. Online J. 12 (7): 5. PMID 17459291.CS1 maint: Multiple names: authors list (link)
-  Browning J, Rosen T (2005). "Terra firma-forme dermatosis revisited". Dermatol. Online J. 11 (2): 15. PMID 16150223.
-  Poskitt L, Wayte J, Wojnarowska F, Wilkinson JD (May 1995). "'Dermatitis neglecta': unwashed dermatosis". Br. J. Dermatol. 132 (5): 8279. doi:10.1111/j.1365-2133.1995.tb00736.x. PMID 7772495.CS1 maint: Multiple names: authors list (link)
-  Jump up to: 6.0 6.1 6.2 6.3 6.4 "Dermatology Atlas".